A 56-year-old woman comes to the physician because of a 4-month history of fatigue, dry mouth, blurry vision, and a persistent nonproductive cough. She does not have shortness of breath, a rash, or joint pain. She has no history of serious illness and takes no medications. She does not smoke or drink alcoholic beverages. Temperature is 37.2°C (99.0°F), pulse is 76/min, respirations are 12/min, and blood pressure is 124/72 mm Hg. Physical examination shows mild conjunctival erythema and cracking of the lips. There is diffuse, nontender thyroid enlargement, which is unchanged from prior examination. The remainder of the examination is normal. Biopsy of the lip mucosa is most likely to reveal which of the following findings?

Question

A 56-year-old woman comes to the physician because of a 4-month history of fatigue, dry mouth, blurry vision, and a persistent nonproductive cough. She does not have shortness of breath, a rash, or joint pain. She has no history of serious illness and takes no medications. She does not smoke or drink alcoholic beverages. Temperature is 37.2°C (99.0°F), pulse is 76/min, respirations are 12/min, and blood pressure is 124/72 mm Hg. Physical examination shows mild conjunctival erythema and cracking of the lips.  There is diffuse, nontender thyroid enlargement, which is unchanged from prior examination.  The remainder of the examination is normal.  Biopsy of the lip mucosa is most likely to reveal which of the following findings?

Quizplus · Accepted Answer

Eductional Objective: Sjögren syndrome is an autoimmune disorder characterized by inflammation of exocrine glands.  Biopsy of the labial salivary glands shows periductal lymphocytic infiltrates (focal lymphocytic sialadenitis), often with germinal centers; the glandular tissue is typically atrophic and fibrotic.

A 56-Year-Old Woman Comes to the Physician Because of a 4-Month