Purchase this article with an account.
R.A. Zaldivar, J.A. Garrity, D.R. Salomão; Granulomatous Inflammation Involving Lacrimal Glands: A Clinico–Pathological Review of Surgical Biopsies Performed in the Past 10 Years . Invest. Ophthalmol. Vis. Sci. 2006;47(13):1949.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Review of the clinical and histopathological findings of lacrimal gland biopsies, performed at the Mayo Clinic between 1994 and 2005, with a final diagnosis of granulomatous inflammation.
A computerized search, using the accession code for lacrimal gland, was performed for all mayo Clinic patients who had lacrimal gland biopsies submitted between 1994 and 2005. All surgical reports, histopathological findings, and pertinent clinical data were reviewed and recorded. Cases in which the final diagnosis was granulomatous inflammation constituted the scope of this study.
One hundred thirty nine lacrimal gland biopsies were performed during this 11–year time period, from 91 women and 48 men, mean age 48 years (range: 2–88 years). The majority of the lesions (91%) were non–epithelial in nature, represented by inflammatory processes (61 cases) or malignant lymphoma (23 cases). The remaining cases (9%) were represented by benign lacrimal cysts (2) or epithelial neoplasms (2 pleomorphic adenomas, 3 adenoid cystic carcinomas, 1 squamous cell carcinoma, 1 mucoepidermoid carcinoma, 1 sebaceous cell carcinoma, 1 high grade adenocarcinoma, and 1 adenocarcinoma with apoccrine differentiation). Of the inflammatory processes involving the lacrimal gland, most were non–specific chronic inflammation (48 cases) and only 13 cases proved to be granulomatous inflammation in the biopsy. The latter cases were from 10 women and 3 men, mean age 46 years (range 18–88). Ten of these biopsies showed non–necrotizing granulomatous inflammation, and only three biopsies had focal necrosis associated to the granulomas. Special stains for fungi and mycobacteria were negative in all biopsies. Upon clinical review, six cases of non–necrotizing inflammation represented sarcoidosis, and four cases, 3 with necrotizing inflammation, were manifestations of Wegener’s granulomatosis. In the remaining three cases the etiology could not be determined despite extensive clinical workup.
Granulomatous inflammation involving the lacrimal gland is uncommon, however, when present, it is most commonly a manifestation of sarcoidosis or Wegener’s granulomatosis.
This PDF is available to Subscribers Only