Case Study: February 2014
- A 70 year old female has a mass in the lacrimal sac associated with chronic epiphora.
- The patient undergoes a dacryocystectomy.
- See figs 1,2 and 3
- What is the histological reaction pattern seen?
- What is the likeliest diagnosis?
- What is the differential diagnosis?
Click to show answers
- This is a granulomatous inflammatory response. There are non-caseating granulomas present in the wall of the sac, composed of epithelioid histiocytes.
- Sarcoid dacryocytitis-although a diagnosis of exclusion.
- Differential for granulomas: Mycobacterial and fungal infection, foreign body, granulomatous vasculitis, VKH, Crohn’s, paraneoplastic granulomas, lymphoma.