Purchase this article with an account.
Judy Chen, Vinay Kumar Aakalu, Pete Setabutr; Prevalence of the Histopathologic Etiologies of Lacrimal Gland Lesions. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):4750.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To describe the prevalence of the etiologies of lacrimal gland lesions treated at a tertiary, urban referral center in the United States, as proven by histopathologic diagnosis from surgical biopsy.
A retrospective chart review was performed of the clinical records of patients who underwent lacrimal gland biopsy by the oculoplastics service from 2010 to 2014 at a tertiary, urban referral center in the United States. Data such as patient demographics, clinical presentation, imaging studies, and pathologic diagnosis were recorded.
Forty patients with lacrimal gland lesions were identified. Twenty-eight (70%) of patients were female and twelve (30%) were male. The average age at presentation was 42±14 years. Eleven (28%) of patients presented with bilateral disease while twenty-nine (72%) presented with unilateral disease. Symptomatically, nineteen (48%) presented with pain, ten (25%) with visual acuity changes, ten (25%) with diplopia, thirty-two (80%) with lid swelling, twenty-four (60%) with injection, six (15%) with globe displacement, seventeen (43%) with ptosis, and ten (25%) with restriction of extraocular motility. The average duration of symptoms was 51 weeks (range 1 day to 8 years). The most common histopathologic diagnosis was dacryoadenitis (52.5%, n=21), followed by orbital inflammatory syndrome (15%, n=6) and sarcoidosis (10%, n=4). One case each was noted of hemangiopericytoma infiltrating the lacrimal gland, pleomorphic adenoma, recurrent follicular lymphoma, Sjogren’s disease, prolapsed orbital fat, IgG4 sclerosing disease, eosinophilic angiocentric fibrosis (EAF), glass retained foreign body, and retained lacrimal stones.
Lacrimal gland lesions constitute a small portion of patients referred to tertiary care centers. While the vast majority of histopathologic etiologies are inflammatory - specifically dacryoadenitis, orbital inflammatory syndrome, and sarcoidosis - no clinical or imaging features reliably differentiate inflammatory from neoplastic causes. Therefore, lacrimal gland biopsy with histopathologic diagnosis should remain the standard of care.
This PDF is available to Subscribers Only