A 7-year prospective study of routine histopathological evaluation of the lacrimal sac wall incisional biopsy specimens obtained during external dacryocystorhinostomy in adults and a review of the literature.
The most common lacrimal sac pathology is chronic inflammation with or without occlusive fibrosis. However, a substantial number of lacrimal sac-specific pathologies were reported throughout the literature which may mimic chronic inflammation and be misdiagnosed. From a tertiary ophthalmic care centre in Serbia, in a single ophthalmic pathology laboratory, during a 7-year period (January 2004 to October 2010), a 599 consecutive lacrimal sac wall biopsy samples routinely obtained during external dacryocystorhinostomy in adult patients with clinically presumed primary acquired lacrimal drainage system obstruction were analysed. Although non-specific lacrimal sac pathology was present in the vast majority of cases (578 biopsy specimens; 96.49%), this report also reveals a relatively substantial number (21 biopsy specimens; 3.51%) of clinically non-suspected or intraoperatively unexpected primary lacrimal sac-specific pathology--among them, six lesions with malignant biological behaviour were identified: one microinvasive squamous cell carcinoma and five malignant lymhoproliferative lesions. Usefulness of routine lacrimal sac wall biopsy during surgery for primary acquired lacrimal drainage system obstruction is undoubtful and commensurate with the constant need for better understanding of the pathological processes that involve lacrimal drainage system.
Institute of Ophthalmology, Clinical Centre of Serbia, Pasterova 2, 11000 Belgrade, Serbia. knelemik@gmail.com
Miroslav
M
Knežević
M
M
Stojković
M
M
Jovanović
Z
Z
Stanković
Dejan M
DM
Rašić
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D003608:Dacryocystorhinostomy; D005260:Female; D006801:Humans; D007765:Lacrimal Apparatus / Q000473:pathology* / Q000601:surgery; D007766:Lacrimal Apparatus Diseases / Q000175:diagnosis* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
Ophthalmic Plast Reconstr Surg. 1992;8(1):13-21
1554647
Ophthalmology. 2002 Jul;109(7):1214-7; discussion 1217-8
12093640
Br J Ophthalmol. 2005 Dec;89(12):1589-91
16299137
Ophthalmology. 2001 Nov;108(11):2038-40
11713075
Ophthalmologe. 2010 Dec;107(12):1139-44
20535481
Br J Ophthalmol. 2006 Aug;90(8):1004-9
16672329
Leukemia. 2007 Mar;21(3):389-96
17230229
Int Ophthalmol Clin. 1982 Spring;22(1):121-40
6277817
Orbit. 2001 Sep;20(3):163-172
12045908
Ophthalmic Plast Reconstr Surg. 2003 Sep;19(5):412; author reply 412-3
14506433
Ophthalmic Plast Reconstr Surg. 2006 Mar-Apr;22(2):96-101
16550051
Ophthalmology. 1986 Aug;93(8):1055-63
3763155
Ophthalmic Plast Reconstr Surg. 2005 Jan;21(1):59-64
15677954
Orbit. 2010 Feb;29(1):11-5
20302403
Orbit. 2010 Oct;29(5):254-8
20704489
Curr Opin Ophthalmol. 2002 Oct;13(5):303-9
12218461
Orbit. 2010 Oct;29(5):250-3
20812824
Ophthalmic Plast Reconstr Surg. 1994 Sep;10(3):169-84
7947444
Ophthalmology. 2003 Dec;110(12):2434-5; author reply 2435-6
14644742
Am J Ophthalmol. 1973 Jul;76(1):73-88
4352147
Ophthalmic Plast Reconstr Surg. 2003 May;19(3):173-6
12918549
Orbit. 2010 Oct;29(5):298-306
20958177
Acta Ophthalmol Scand. 2005 Feb;83(1):94-9
15715565
Ophthalmic Plast Reconstr Surg. 1993;9(1):11-26
8443110
Ophthalmology. 1997 Nov;104(11):1882-6
9373121