This 50 year old African American woman presented with a 6 month history of painless, progressive bilateral lacrimal enlargement without any other ocular complaints.
1. What is the differential diagnosis for chronic, bilateral lacrimal gland enlargement?
2. What other information from the patient’s history and examination would be helpful in narrowing the diagnosis?
3. What additional tests would help to confirm the diagnosis?
4. How would you manage this patient?
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