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Seymour Brownstein, Kay Lam, Andre Jastrzebski, David Jordan, Joseph de Nanassy; Dacryops: A Series Of Six Cases And A Review Of The Literature. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4936.
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To present a series of 6 cases of lacrimal gland ductal cysts, also known as dacryops, which is an uncommon condition. The clinical descriptions, histopathological findings, and immunohistochemical stains were analyzed.
Our 6 cases included 4 from the palpebral lobe and 1 from the orbital lobe of the main lacrimal gland and 1 from a gland of Krause in the inferior fornix. We also reviewed the clinical patient information. In this retrospective series, the 6 cases were confirmed histologically to arise from ductal epithelium. Histopathological and immunohistochemical studies including sections stained with hematoxylin-eosin, periodic acid-Schiff, glycosaminoglycan stains, and monoclonal antibodies against immunoglobulins were performed. We also assessed the nature of the cyst epithelium, the presence of mucus-secreting goblet cells, and the associated inflammatory infiltrate.
The 6 cases displayed similar histopathologic features compatible with dacryops including a cyst lined by a double layer of non-ciliated epithelium; the inner layer was columnar with apical changes of apocrine secretion and the outer cellular layer was slightly flattened with variable number of goblet cells in 4 cases, more flattened in both layers in 1 case, and 1 case showed stratified squamous epithelium blending with a double columnar layer. Subepithelially, inflammatory cells were frequently identified in areas surrounding the cyst, especially in the lacrimal gland tissue. IgA staining was positive in the apices of the luminal cells, while IgM and IgG staining were negative in the same areas. We propose that the histopathological and immunohistochemical findings may play a pathogenetic role for the evolution of this condition.
We present one of the largest recent reviews of dacryops with current immunohistochemical stains. Only 9 cases have been reported in the reviewed English literature in the last decade of this well-recognized, but poorly understood condition. Our series reviews the distinguishing histopathological features and immunoreactivity of dacryops, which can be differentiated from other more commonly occurring cystic lesions in the orbit and ocular adnexa.
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