Chronic canaliculitis caused by fusobacterium Plaut-Vincenti and Borrelia Vincentii.
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Borrelia↗
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Results for “LACRIMAL APPARATUS”
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Functional exploration of the lacrimal gland by tear electrophoresis.
Electrophoresis of tears, a rapid and easy technique, shows several peaks of migration. Three main peaks correspond to the proteins synthesized by the lacrimal gland: rapid migrant proteins, lactoferrin migrating to the anode, and lysozyme migrating to the cathode. Secretory tissue injuries of the lacrimal gland show a more or less important decrease of one or several peaks. Any inflammatory reaction induces an increase in the serum albumin and immunoglobulin fractions. This exploration can be helpful in the diagnosis of the sicca syndrome or of drug poisoning thereby avoiding lacrimal biopsy.
Electrophoresis, Cellulose Acetate↗
Recurrent mixed tumor of the right lacrimal gland causes acute contralateral visual loss.
A 23-year-old woman underwent excisional biopsy of a right palpebral mass: the histopathologic study showed a benign mixed tumor of the lacrimal gland. Thereafter, the tumor recurred repeatedly, and multiple excisions were done. Subsequently, right orbital exenteration was performed, and some orbital and frontal bones were removed. When the patient was 52 years old, the orbital tumor recurred. A histopathologic study revealed malignant transformation. At the age of 54 years, the patient suffered acute loss of vision in her left eye. Computed tomography disclosed invasion of the tumor into the posterior paranasal sinuses and brain.
Adenoma↗
Canalicular reconstruction for difficult cases: lacrimal stents and multiple traction sutures.
Twelve cases with canalicular disorders were treated by a new technique using multiple traction sutures (MTS) under an operating microscope. The MTS using black silk or 5-0 nylon were applied at the medial canthus, near the upper and lower puncta and at the caruncle. Additional traction sutures were applied to locate a deep canalicular system if needed, resulting in a total of 5-10 traction sutures. The patient's face was turned sideways towards the left in the operation of the right eye, and to the right in the operation of the left eye. By using the new technique, the opening of the common canaliculus could easily be located without resorting to an open-sky technique requiring skin incision. A new canaliculus could easily be made using a free graft of oral mucous membrane between the common canaliculus and medial canthus with the help of MTS in 7 cases out of 12. As stents, a match-style silicone tubing, a nunachaku-style silicone tubing, an ordinary silicone tubing and a silicone tubing with a silicone sponge were used for 7, 1, 1 and 3 cases, respectively. After a mean follow-up 17.2 months, symptomatic relief and patency of the lacrimal passage were achieved in all cases.
Adult↗
Imaging techniques in the diagnosis of lacrimal sac diverticulum.
Lacrimal sac diverticulum is a rare condition characterized by a cystic structure communicating with the sac. This abnormality may be directly demonstrated by dacryocystography only in a few cases; in the remaining cases, preoperative diagnosis may be arduous. We report 3 cases of lacrimal sac diverticulum. In all patients, symptoms were represented by a palpable mass in the lacrimal sac region, associated with permanent (case 1) or episodic (cases 2 and 3) epiphora. In the first case, CT-dacryocystography revealed an apparently solid mass causing inferior lacrimal obstruction, and ultrasonography disclosed a cystic space, not communicating with the sac. At surgery, a sac diverticulum was identified and excised. In the second patient, CT showed a homogeneous rounded mass, whereas a cystic character was revealed by T1-weighted MRI. Dacryocystography showed a lateral impression on the lateral wall of the sac. Ultrasonography revealed a cystic space communicating with the lacrimal sac. In the third case, ultrasonography demonstrated a diverticulum. CT is often unable to discriminate tumors from lacrimal cysts, both showing a parenchymal density. MRI can differentiate lacrimal cystic spaces from solid tumors by T1 intensity and by demonstration of their walls, but it is nonspecific for diverticula. Only dacryocystography and B-scan ultrasonography can reveal the narrow communication between the sac and the diverticulum. Observation is the recommended management for asymptomatic cases.
Adolescent↗
Microsurgery in lacrimal disorders.
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Humans↗
Lacrimal gland involvement in graft-versus-host disease: a murine model.
PURPOSE: To describe lacrimal gland involvement in a murine model of acute graft-versus-host disease (GVHD). METHODS: Histopathologic examination was performed on lacrimal glands of mice affected by GVHD at 1, 2, 4, and 6 weeks after allogeneic bone marrow transplantation (BMT). Histopathologic scoring, based on characteristic GVHD findings in human disease involved evaluation of periductal inflammation, apoptosis, ductal stasis, ductal debris, and fibrosis. CD3, CD4, CD8, CD20, and CD68 antibodies were used to stain leukocyte subsets in GVHD lacrimal gland infiltrates. Lacrimal glands from syngeneic BMT mice were used in control experiments. RESULTS: Patchy periductal inflammation and focal fibrosis were significantly elevated as early as 2 weeks after allogeneic BMT. Histopathologic scoring of lacrimal glands after allogeneic BMT was significantly different at 4 (P = 0.005) and 6 (P < 0.0001) weeks when compared with scores in syngeneic control mice. The leukocytes in lacrimal gland GVHD infiltrates were predominately CD3+ T lymphocytes, most of which were CD8+, with fewer CD4+ cells present. CONCLUSIONS: This study describes the first murine model of lacrimal gland GVHD with features that closely mimic those described in human disease and indicates that lacrimal involvement occurs in acute GVHD.
Acute Disease↗
Donor fibroblast chimerism in the pathogenic fibrotic lesion of human chronic graft-versus-host disease.
PURPOSE: Tissue atrophy and excessive fibrosis are prominent histologic features of chronic graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation, but the underlying mechanism remains unknown. The current study was undertaken to investigate whether the increase in fibroblasts at the site of pathogenic fibrosis originated from transplanted donor cells in patients with chronic GVHD. METHODS: Lacrimal gland biopsy specimens were obtained from nine patients with chronic GVHD. The male-specific sequences detected by fluorescein in situ hybridization (FISH) and in situ hybridization (ISH) were used as markers for the donor cells in seven female patients who had received a transplant from male donors. Primary fibroblast cultures were generated from lacrimal gland biopsy specimens and examined for mismatched genetic markers between recipients and donors. RESULTS: In lacrimal gland specimens obtained from seven female patients who received a sex-mismatched transplant, 13.4% to 26.7% of CD34+ fibroblasts that accumulated in the fibrotic lesion were donor derived, as determined by FISH for the Y-chromosome. The male-specific mRNA was also detected in the lacrimal gland fibroblasts by ISH. Primary lacrimal gland fibroblast cultures were generated from four patients with chronic GVHD and further examined for mismatched genetic markers between recipients and donors. As a result, the presence of donor origin of the fibroblasts was demonstrated by detecting the Y-chromosome sequence and donor-specific microsatellite genetic markers. CONCLUSIONS: These findings together indicate the chimeric status of accumulated CD34+ fibroblasts in the lacrimal gland of patients with chronic GVHD. Fibroblasts originating from circulating donor-derived precursors may participate in the excessive fibrosis in these patients.
Adult↗
Case report: carcinoma of the extraorbital lacrimal gland in a female Fischer 344 rat.
A large subcutaneous mass was observed at necropsy in the right neck area of a 95-week-old female Fischer 344 rat that served as an untreated control animal in a 2-year carcinogenicity study. Formalin-fixed, paraffin-embedded sections of the mass were stained with hematoxylin and eosin along with the immunohistochemical biomarkers lactoperoxidase, catalase, and amylase. Based on its histomorphological and immunohistochemical features, the lesion was diagnosed as a carcinoma of the extraorbital lacrimal gland.
Adenocarcinoma↗
Dacryocystorhinostomy utilizing an anterior lacrimal sac flap to periosteum technique.
Dacryocystorhinostomy is used in the effective treatment of epiphora secondary to obstruction of the lacrimal drainage system. Common causes of obstruction include canalicular disruption, lacrimal sac fibrosis, and external and internal nasal trauma. Most techniques of dacryocystorhinostomy attempt to suture the lacrimal sac mucosa to the nasal mucosa. At best this is technically difficult, and the mucosa frequently tears. A technique is presented using an anteriorly based lacrimal sac pedicle flap sutured to the periosteum of the anterior lacrimal crest. The sutured flap is quite strong, and the procedure is technically simpler than others. A brief description of the causes of lacrimal obstruction is given. The Jones primary and secondary dye tests for lacrimal system patency are reviewed.
Humans↗
Reflex epiphora in patients with dry eye symptoms: role of variable time Schirmer-1 test.
PURPOSE: To report reflex epiphora in patients with dry eye symptoms and describe the role of variable time Schirmer-1 test. METHODS: The study was conducted in 16 consecutive dry eye patients (32 eyes), nine male and seven female, aged 16 to 73 years (mean 48.56-/+16.68 years), presenting with reflex epiphora. Each eye was subjected to Schirmer-1 test and the time elapsed in total wetting of the 35 mm strip from its placement into the conjunctiva was noted and test was graded. This was compared with symptomatology, closed chamber infrared thermometry, humidity, fluorescein tear break-up time (FTBUT), fluorescein stain test, and Lissamine green stain. RESULTS: Schirmer-1 test differentiated reflex epiphora in dry eye patients into groups 0 to 4 based on time it took to wet the 35 mm strip (Group 0 = <=5 min; Group 1 = <=2 min; Group 2 = <=1.5 min; Group 3= <=1 min; Group 4 = <=1/2 min). The score was -0.04 in 8 eyes, -0.03 in 10 eyes, -0.02 in 2 eyes, -0.01 in 6 eyes, and 0.00 in 6 eyes in Groups 4, 3, 2, 1, and 0, respectively. Reflex epiphora had a statistically significant correlation to the symptomatology (p<0.001), lissamine green staining (p<0.001), closed chamber humidity difference (p<0.001), and FTBUT score (p=0.001). Fluorescein stain test and difference in infrared thermometry did not show any correlation. A statistically significant correlation existed between severe and mild to moderate reflex epiphora (p=0.002). However, the two groups separately failed to show any statistically significant relationship with the symptomatology (p=0.16), Lissamine green (p=0.69), humidity difference from close to open eye position (p=0.17), and FTBUT (p=0.25). Thermometry and fluorescein stain test showed no relationship. CONCLUSIONS: Schirmer-1 test with variable time quantifies reflex epiphora in dry eye patients, which was significantly related to the other tear function tests.
Adolescent↗
Orbital cyst of lacrimal sac derivation.
Orbital cyst from lacrimal sac epithelium is rare and thought to originate from diverticulum of the lacrimal sac. The cyst may have direct communication with the sac, or the two structures may be anatomically separate. Since these lesions most commonly present as a medial canthal mass, the differential diagnosis should include other disorders that may cause a mass in this region. A 42 year old woman presented with a two-year history of a mass in the right medial canthal region. Nasolacrimal system was patent on irrigation. Sophisticated radiological investigation utilizing dacryocystography and computed tomography combined with dacryocystography accurately localized the lesion and demonstrated its relationship to the nasolacrimal system. This tremendously facilitated surgical removal. The lesion was excised completely via anterior orbitotomy and submitted for histopathologic examination. Haematoxylin-eosin stains revealed a cystic cavity lined by pseudostratified columnar and cuboidal epithelium with interspersed goblet cells consistent with a cyst derived from lacrimal sac epithelium, located separately, but in close proximity to the lacrimal sac. The Authors present a patient with a mass in the righ medial canthal area histologically diagnosed as an orbital cyst of lacrimal sac epithelium derivation. Sophisticated radiological lacrimal investigation helps in detection, localization and in planning surgery.
Adult↗
Exophthalmos in ageing rats with Harderian gland disease.
Exophthalmos was found in aged rats in several longevity studies. Four cases were due to malignant Harderian gland neoplasia whilst others were associated with severe Harderian gland inflammation, less severe inflammation being found in rats without exophthalmos.
Aging↗
Intubation dacryocystography in patients with a clinical diagnosis of chronic canaliculitis ("streptothrix").
Magnification dacryocystography in 18 patients with chronic infective canaliculitis showed dilatation and irregularity of the affected lacrimal canaliculi, with prominent filling defects in almost all cases. Filling defects are uncommon in other diseases of the canaliculi and serve to confirm the diagnosis.
Adolescent↗
Technical note: computed tomographic dacryocystography.
The technique of computed tomographic dacryocystography is described. It was developed in response to the pre-operative imaging requirements for transnasal endoscopic dacryocystorhinostomy, a new minimally invasive operation performed as a primary procedure to relieve epiphora. However, it is also helpful in the assessment of patients after failed conventional external dacryocystorhinostomy when the information provided will help to determine the subsequent surgical approach. In addition the technique will assist surgical planning in cases of epiphora associated with sinus surgery, facial trauma and maxillofacial tumours by determining the site and extent of pathology.
Dacryocystorhinostomy↗
Pleomorphic adenoma of the lacrimal gland manifesting as exophthalmos in adolescence--case report.
A 16-year-old girl presented with a pleomorphic adenoma of the lacrimal gland manifesting as left painless exophthalmos which had persisted for 3 years. Computed tomography revealed a tumor about 15 mm in diameter in the superolateral site of the left orbit. The tumor was removed completely by combined orbitofrontal craniotomy through a transcranial approach. Histological examination demonstrated the growth of tumor cells as glandular cavities or sheets, with myxoid and partly chondroid connective tissue stroma. Pleomorphic adenoma of the lacrimal gland is unusual in adolescents.
Adenoma, Pleomorphic↗
Unusual progression of pleomorphic adenoma of the lacrimal gland: case report.
A 72-year-old female complained of acute pain on left eye movement followed by progressive exophthalmos. Neuroimaging revealed a large well-demarcated lesion consisting of solid and cystic parts, as well as bone destruction and hemorrhage, within the left orbital cavity. The preoperative diagnosis was pleomorphic adenoma with or without malignant transformation, or cavernous angioma. En bloc excision including adjacent tissues was planned to resolve the progressive symptoms and to obtain a histological diagnosis. The transcranial route was chosen since tumor invasion to the cranial base was possible. The histological diagnosis was pleomorphic adenoma. Pathological and preoperative radiological examinations indicated that repeated intratumoral hemorrhage had caused the orbital bone destruction and acute orbital pain. Neoplasms should be differentiated from a wide spectrum of other possible pathologies. Accurate clinical diagnosis of neoplasm in the orbital cavity is important for correct therapeutic management. Malignancy is generally suspected if painful and progressive signs and symptoms are associated with an orbital mass lesion. The present case suggests that pleomorphic adenoma should also be considered in the differential diagnosis. The therapeutic strategy for lacrimal gland tumors remains controversial, so a flexible management approach is required.
Adenoma, Pleomorphic↗
Focal adenitis in lacrimal and salivary glands. A post-mortem study.
In the present study the submandibular, labial, and lacrimal glands of 102 postmortem subjects were studied as to the presence of inflammatory foci, fibrosis, atrophy and fatty change. Focal lymphocytic infiltration of these glands with focus scores exceeding 1, one of the findings on which the diagnosis of Sjögren's syndrome is based, was found in 19 cases (18.6%). Fibrosis, atrophy, and fatty change occurred most often in the labial salivary glands of patients over 50 years of age with or without high focus scores. Fibrosis, atrophy and fat infiltration hardly ever occurred in the lacrimal glands although this was the type of gland in which high focus scores occurred most often. The findings suggest that a wider than hitherto recognized spectrum of systemic inflammatory diseases may contribute to lymphocytic adenitis and degeneration of the exocrine glands. The diagnosis of Sjögren's syndrome should be confirmed by additional diagnostic tests.
Adipose Tissue↗