Clinical -to- Pathological Correlation of Lacrimal Sac Specimens Obtained During Dacryocystorhinostomy Surgery

Abstract

Idiopathic chronic inflammation, with or without fibrosis, occurs in clinically presumed primary acquired nasolacrimal duct obstruction (PANDO). A wide variety of causes, such as specific inflammatory, traumatic, mechanical, or neoplastic may mimic idiopathic inflammation in secondary acquired nasolacrimal duct obstruction (SANDO). Neoplastic causes are of special clinical interest. (23) Obstruction of the lacrimal drainage system by a neoplasm is rare but can be potentially life-threatening. Patients with lacrimal sac tumors may demonstrate clinical signs such as bloody tears, a visible or palpable mass and bloody reflux on diagnostic irrigation of the lacrimal system. However, some patients with lacrimal sac tumors do not present with the typical symptoms and signs and the condition may mimic chronic dacryocystitis or involutional nasolacrimal duct obstruction, which may delay proper diagnosis and treatment. (7) The current literature on the role of routine histopathologic sampling of the lacrimal sac during DCR is controversial. Some publications recommended routine lacrimal sac biopsy, whereas others advocated biopsy only in selected cases. (24)