Clinicopathologic findings from lacrimal sac biopsy specimens obtained during dacryocystorhinostomy.
OBJECTIVE
To retrospectively review the pathologic diagnoses and clinical characteristics of patients undergoing dacryocystorhinostomy (DCR).


METHODS
Specimens accessioned between 1991 and 2001 in a single ophthalmic pathology laboratory were reviewed. All of the specimens included a lacrimal sac biopsy specimen. The pathologic diagnoses were recorded. The clinical features of the patients with significant pathologic abnormalities were reviewed to determine if the pathology was suspected before or at the time of the DCR.


RESULTS
There were 377 DCR specimens from 316 patients representing 1.8% of 21,018 ophthalmic pathology specimens accessioned between 1991 and 2001. Diagnoses, in decreasing order of frequency, were nongranulomatous inflammation (321, 85.1%), granulomatous inflammation consistent with sarcoidosis (8, 2.1%), lymphoma (7, 1.9%), papilloma (4, 1.11%), lymphoplasmacytic infiltrate (4, 1.1%), transitional cell carcinoma (2, 0.5%), and single cases of adenocarcinoma, undifferentiated carcinoma, granular cell tumor, plasmacytoma, and leukemic infiltrate. A total of 31 (8.2%) specimens from 25 (7.9%) of patients demonstrated significant pathology. Among 17 specimens (4.5%) from 14 patients with neoplasms whose clinical histories were available, 8 (2.1%) were not suspected before surgery.


CONCLUSIONS
Nongranulomatous inflammation consistent with chronic dacryocystitis is the most common diagnosis in lacrimal sac specimens obtained at DCR. Neoplasms resulting in chronic nasolacrimal duct obstruction occurred in 4.6% of cases and were unsuspected before surgery in 2.1% of patients. We recommend pathologic examination of DCR specimens.
Anderson
Nicholas G
NG
Department of Ophthalmology, Emory University, Atlanta, Georgia, USA.
Wojno
Ted H
TH
Grossniklaus
Hans E
HE
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003607:Dacryocystitis / Q000453:epidemiology / Q000473:pathology; D003608:Dacryocystorhinostomy; D005134:Eye Neoplasms / Q000453:epidemiology / Q000473:pathology; D005260:Female; D006801:Humans; D015994:Incidence; D007432:Intraoperative Period; D007765:Lacrimal Apparatus / Q000473:pathology*; D007766:Lacrimal Apparatus Diseases / Q000453:epidemiology / Q000473:pathology; D007767:Lacrimal Duct Obstruction / Q000453:epidemiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009301:Nasolacrimal Duct; D012189:Retrospective Studies