Purpose: To analyse clinical referral diagnoses and the location of lesions wi th histologically verified lacrimal gland tissue occurring outside the fossa of the lacrimal gland. Methods: Sections of lesions excised f...Purpose: To analyse clinical referral diagnoses and the location of lesions wi th histologically verified lacrimal gland tissue occurring outside the fossa of the lacrimal gland. Methods: Sections of lesions excised from areas outside the fossa of the lacrimal gland containing lacrimal gland tissue on histological exa mination were collected from the files of the Eye Pathology Institute, Copenhage n, Denmark. Specimens spanned a period of 50 years. Sections were re-examined a nd referral data on location and clinical diagnosis were compared with histologi cal findings. Results: A total of 120 lesions were collected. Of these, 59 (49% ) consisted of prolapsed lacrimal gland. The remaining 61 (51%) lesions contain ed ectopic lacrimal gland tissue, either as part of a complex choristoma in 38 ( 32%) cases, or as solitary ectopic lacrimal gland tissue in 23 (19%) cases. Th e majority (97; 81%) of lesions had been located at the temporal epibulbar conj unctiva and included mainly prolapsed lacrimal gland and complex choristoma. The clinical referral diagnoses covered a wide spectrum of lesions. The most freque nt clinical diagnoses were non-specific tumour (35%), non-specific cyst (18% ) and dermoid (11%). Of the 61 lesions containing ectopic lacrimal gland tissue , only two had been preoperatively diagnosed as such and only two of the 59 lesi ons with prolapsed lacrimal gland had been correctly diagnosed. Conclusions: Pro lapsed palpebral lobe of the lacrimal gland was the most common lesion and, as e xpected, the prime location was the temporal conjunctiva. Despite this location, the referring clinical diagnosis was often wrong or non-specific. Surgeons see m to have been unaware of the various clinical manifestations of extrafossal gla ndular tissue, particularly when excising lesions in the upper temporal region o f the conjunctiva. Surgical intervention in this location may jeopardizethe excr etory ducts of the lacrimal gland and may consequently lead to dry eye and thus should be avoided when the typical clinical appearance of prolapsed lacrimal gla nd is encountered.展开更多
Purpose: To determine the frequency of histologically verified lesions of the lacrimal drainage system in Denmark between the years 1910 and 1999. Furthermore , to correlate the clinical diagnosis with the pathology d...Purpose: To determine the frequency of histologically verified lesions of the lacrimal drainage system in Denmark between the years 1910 and 1999. Furthermore , to correlate the clinical diagnosis with the pathology diagnosis. Methods: Ret rospective review of all pathology reports from 1910 to 1999 in the files of the Eye Pathology Institute, University of Copenhagen, describing a lesion of the l acrimal drainage system. In addition, a retrospective review of all reports desc ribing a lesion of the lacrimal drainage system from the Danish Pathology Databa se. All specimens were re-evaluated, except in cases with a primary diagnosis o f dacryocystitis. In these cases a sample of 25%was re-evaluated. Results: A t otal of 643 lesions were collected. Dacryocystitis was the most frequent lesion, constituting 508 cases (79%). The remaining cases were diagnosed as dacryolith iasis (62 cases; 7.9%), tumour (29 cases; 4.5%), trauma (19 cases; 3.0%), con genital malformation (nine cases; 1.4%), canaliculitis (eight cases; 1.2%) and granulomatous inflammation (eight cases; 1.2%). Seventeen tumours were maligna nt, of which B-cell lymphoma was the most common (six cases). In 0.6%of cases with a clinical diagnosis of dacryocystitis/lithiasis a non-suspected malignant tumour was diagnosed. Micro-organisms were uncommon in dacryocystitis (9%) bu t frequent in cases of dacryolithiasis (87%). Conclusion: Dacryocystitis was by far the most frequent lesion of the lacrimal drainage system referred for histo pathological evaluation. Dacryolithiasis was often associated with micro-organi sms, especially Gram positive rods. Histopathology is necessary to confirm suspe cted tumours, more than half of which were inflammatory lesions, and to detect t umours that sometimes masquerade as inflammation.展开更多
Purpose: To carry out a retrospective clinicopathological evaluation of caruncular lesions. Methods: Data were collected from all surgically removed and histopathologically evaluated caruncular lesions registered by D...Purpose: To carry out a retrospective clinicopathological evaluation of caruncular lesions. Methods: Data were collected from all surgically removed and histopathologically evaluated caruncular lesions registered by Danish pathology departments during the 25- year period 1978- 2002. Results: A total of 574 caruncular lesions were identified. The number of caruncular lesions increased significantly during the 25- year period. This was due to an increase in the number of benign lesions, whereas the number of premalignant and malignant lesions remained constant. A total of 550 (96% ) of the lesions were benign. Naevus (n=248, 43% ) and papilloma (n=131, 23% ) were the most common neoplasms. Premalignant lesions (n=10, 1.7% )- were dominated by primary acquired melanosis (PAM) with atypia and epithelial dysplasia. Malignant lesions constituted a total of 14 neoplasms (2.4% ), with basal cell carcinoma (n= 4, 0.7% ) and lymphoma (n=4, 0.7% ) being the most frequent. The preoperative clinical diagnosis was correct in 286 (50% )- of cases. Conclusion: Caruncular lesions are predominately benign but the lesions are rare and diverse, making clinical diagnosis difficult. Referral of excised lesions for pathological examination is recommended.展开更多
文摘Purpose: To analyse clinical referral diagnoses and the location of lesions wi th histologically verified lacrimal gland tissue occurring outside the fossa of the lacrimal gland. Methods: Sections of lesions excised from areas outside the fossa of the lacrimal gland containing lacrimal gland tissue on histological exa mination were collected from the files of the Eye Pathology Institute, Copenhage n, Denmark. Specimens spanned a period of 50 years. Sections were re-examined a nd referral data on location and clinical diagnosis were compared with histologi cal findings. Results: A total of 120 lesions were collected. Of these, 59 (49% ) consisted of prolapsed lacrimal gland. The remaining 61 (51%) lesions contain ed ectopic lacrimal gland tissue, either as part of a complex choristoma in 38 ( 32%) cases, or as solitary ectopic lacrimal gland tissue in 23 (19%) cases. Th e majority (97; 81%) of lesions had been located at the temporal epibulbar conj unctiva and included mainly prolapsed lacrimal gland and complex choristoma. The clinical referral diagnoses covered a wide spectrum of lesions. The most freque nt clinical diagnoses were non-specific tumour (35%), non-specific cyst (18% ) and dermoid (11%). Of the 61 lesions containing ectopic lacrimal gland tissue , only two had been preoperatively diagnosed as such and only two of the 59 lesi ons with prolapsed lacrimal gland had been correctly diagnosed. Conclusions: Pro lapsed palpebral lobe of the lacrimal gland was the most common lesion and, as e xpected, the prime location was the temporal conjunctiva. Despite this location, the referring clinical diagnosis was often wrong or non-specific. Surgeons see m to have been unaware of the various clinical manifestations of extrafossal gla ndular tissue, particularly when excising lesions in the upper temporal region o f the conjunctiva. Surgical intervention in this location may jeopardizethe excr etory ducts of the lacrimal gland and may consequently lead to dry eye and thus should be avoided when the typical clinical appearance of prolapsed lacrimal gla nd is encountered.
文摘Purpose: To determine the frequency of histologically verified lesions of the lacrimal drainage system in Denmark between the years 1910 and 1999. Furthermore , to correlate the clinical diagnosis with the pathology diagnosis. Methods: Ret rospective review of all pathology reports from 1910 to 1999 in the files of the Eye Pathology Institute, University of Copenhagen, describing a lesion of the l acrimal drainage system. In addition, a retrospective review of all reports desc ribing a lesion of the lacrimal drainage system from the Danish Pathology Databa se. All specimens were re-evaluated, except in cases with a primary diagnosis o f dacryocystitis. In these cases a sample of 25%was re-evaluated. Results: A t otal of 643 lesions were collected. Dacryocystitis was the most frequent lesion, constituting 508 cases (79%). The remaining cases were diagnosed as dacryolith iasis (62 cases; 7.9%), tumour (29 cases; 4.5%), trauma (19 cases; 3.0%), con genital malformation (nine cases; 1.4%), canaliculitis (eight cases; 1.2%) and granulomatous inflammation (eight cases; 1.2%). Seventeen tumours were maligna nt, of which B-cell lymphoma was the most common (six cases). In 0.6%of cases with a clinical diagnosis of dacryocystitis/lithiasis a non-suspected malignant tumour was diagnosed. Micro-organisms were uncommon in dacryocystitis (9%) bu t frequent in cases of dacryolithiasis (87%). Conclusion: Dacryocystitis was by far the most frequent lesion of the lacrimal drainage system referred for histo pathological evaluation. Dacryolithiasis was often associated with micro-organi sms, especially Gram positive rods. Histopathology is necessary to confirm suspe cted tumours, more than half of which were inflammatory lesions, and to detect t umours that sometimes masquerade as inflammation.
文摘Purpose: To carry out a retrospective clinicopathological evaluation of caruncular lesions. Methods: Data were collected from all surgically removed and histopathologically evaluated caruncular lesions registered by Danish pathology departments during the 25- year period 1978- 2002. Results: A total of 574 caruncular lesions were identified. The number of caruncular lesions increased significantly during the 25- year period. This was due to an increase in the number of benign lesions, whereas the number of premalignant and malignant lesions remained constant. A total of 550 (96% ) of the lesions were benign. Naevus (n=248, 43% ) and papilloma (n=131, 23% ) were the most common neoplasms. Premalignant lesions (n=10, 1.7% )- were dominated by primary acquired melanosis (PAM) with atypia and epithelial dysplasia. Malignant lesions constituted a total of 14 neoplasms (2.4% ), with basal cell carcinoma (n= 4, 0.7% ) and lymphoma (n=4, 0.7% ) being the most frequent. The preoperative clinical diagnosis was correct in 286 (50% )- of cases. Conclusion: Caruncular lesions are predominately benign but the lesions are rare and diverse, making clinical diagnosis difficult. Referral of excised lesions for pathological examination is recommended.
