Amyloid Pseudo-Dacryolith and Nasolacrimal Obstruction in a 67-Year-Old Male.
A 67-year-old male with a 35-year history of left-sided epiphora presented with a nonpainful, noninflamed, left medial canthal mass and complete left nasolacrimal obstruction. During routine dacryocystorhinostomy, a lesion was present within the lacrimal sac that mimicked a lacrimal stone in appearance but with a consistency concerning for malignancy. Histologically, the lesion displayed apple-green birefringence on polarized light microscopy and Congo red staining. The patient was referred to the hematology service for evaluation, which failed to reveal systemic disease. There is 1 previous report of localized amyloidosis to the nasolacrimal excretory system in which the lesion was invasive and caused bony erosion. The authors present a second case of localized, nasolacrimal amyloidosis mimicking both neoplasm and dacryolith without bony erosion.
*Lakeland Eye, Cleveland Clinic, †Case Western Reserve University School of Medicine, and ‡Department of Anatomic Pathology, Cleveland Clinic, Cleveland, Ohio, U.S.A.
Mark R
MR
Levine
Shane B
SB
Seipel
Thomas P
TP
Plesec
Bryan R
BR
Costin
D000368:Aged; D000686:Amyloidosis / Q000150:complications* / Q000175:diagnosis; D001706:Biopsy; D003608:Dacryocystorhinostomy / Q000379:methods*; D006801:Humans; D007765:Lacrimal Apparatus / Q000473:pathology*; D007767:Lacrimal Duct Obstruction / Q000175:diagnosis / Q000209:etiology*; D008297:Male