HIstopathological evaluation of the lacrimal sac wall incisional biopsy specimens obtained during external dacryocystorhinostomy

Poremećaji u odvodnom sistemu suza koji dovode do opstrukcije oticanja istih čest su problem u oftalmologiji. Blokada ekskretornog sistema, kada je normalno oticanje suza u nos onemogućeno, u velikoj većini slučajeva nastaje u predelu suzne kese i/ili suzno-nosnog kanala, a može da bude posledica ne-specifične ili specifične patologije suzne kese i/ili suzno-nosnog kanala. Problemi u oticanju suza u najvećem procentu nastaju kao stečeni i, u odrasloj životnoj dobi. Stečena opstrukcija može da bude primarna/idiopatska ili sekundarna. Kod primarne, još uvek neidentifikovani uzrok doprinosi hroničnom zapaljenju suzne kese, stanju nazvanom primarni hronični dakriocistitis. Različiti etiološki faktori (infekcija, zapaljenje, trauma, mehanička prepreka, toksičko dejstvo ili neoplazma), od kojih pojedini česti, a drugi teško uočljivi, mogu da dovedu do sekundarne stečene opstrukcije distalnog dela odvodnog sistema suza koja klinički imponuje kao idiopatsko zapaljenje. Cilj Utvrđivanje učestalosti nespecifične i specifične primarne patologije suzne kese kao uzroka klinički pretpostavljene primarne opstrukcije odvodnog sistema suza, u datom uzorku incizionih biopsija dobijenih prilikom izvođena spoljašnje dakriocistorinostomije. Analiza patoloških procesa odgovornih za histopatološki potvrđenu primarnu i sekundarnu opstrukciju odvodnog sistema suza. Analiza relevantnih kliničkih podataka pacijenata sa primarnom i sekundarnom opstrukcijom odvodnog sistema suza. Analiza/upoređivanje dobijenih patohistoloških i relevantnih kliničkih podataka...Disorders of the lacrimal drainage system causing tear outflow obstruction are a common problem in ophthalmology. Blockage in the lacrimal excretory outflow system, when normal tear channeling into the nose is impaired, in the vast majority of cases is at the point of the lacrimal sac and/or lacrimonasal duct, and caused by non-specific or specific pathology that involves the lacrimal sac and/or lacrimonasal duct. The majority of obstructions of the lacrimal excretory outflow system is acquired ones, occuring in adulthood, involving the distal parts of the system. Acquired obstruction can be primary/idiopathic or secondary. In the primary, yet unidentified cause contributes to chronic inflammation of the lacrimal sac, condition called primary chronic dacryocystitis. Different etiological factors (infection, inflammation, trauma, mechanical barriers, toxic effects or neoplasm), some of which are common and others hardly visible, can lead to secondary acquired obstruction of the distal part of a lacrimal drainage system clinically impressive as idiopathic inflammation. Aim Determining the frequency of non-specific and specific primary lacrimal sac pathology as a cause of clinically presumed primary acquired lacrimal drainage system obstruction in a given consecutive samples of incisional biopsies obtained during external dacryocystorhinostomy. Analysis of pathological processes responsible for histopathologically confirmed primary and secondary acquired lacrimal drainage system obstruction. Analysis of relevant clinical data of patients with primary and secondary acquired lacrimal drainage system obstruction. Analysis/comparison of obtained histopathological and relevant clinical data..

HIstopathological evaluation of the lacrimal sac wall incisional biopsy specimens obtained during external dacryocystorhinostomy

Poremećaji u odvodnom sistemu suza koji dovode do opstrukcije oticanja istih čest su problem u oftalmologiji. Blokada ekskretornog sistema, kada je normalno oticanje suza u nos onemogućeno, u velikoj većini slučajeva nastaje u predelu suzne kese i/ili suzno-nosnog kanala, a može da bude posledica ne-specifične ili specifične patologije suzne kese i/ili suzno-nosnog kanala. Problemi u oticanju suza u najvećem procentu nastaju kao stečeni i, u odrasloj životnoj dobi. Stečena opstrukcija može da bude primarna/idiopatska ili sekundarna. Kod primarne, još uvek neidentifikovani uzrok doprinosi hroničnom zapaljenju suzne kese, stanju nazvanom primarni hronični dakriocistitis. Različiti etiološki faktori (infekcija, zapaljenje, trauma, mehanička prepreka, toksičko dejstvo ili neoplazma), od kojih pojedini česti, a drugi teško uočljivi, mogu da dovedu do sekundarne stečene opstrukcije distalnog dela odvodnog sistema suza koja klinički imponuje kao idiopatsko zapaljenje. Cilj Utvrđivanje učestalosti nespecifične i specifične primarne patologije suzne kese kao uzroka klinički pretpostavljene primarne opstrukcije odvodnog sistema suza, u datom uzorku incizionih biopsija dobijenih prilikom izvođena spoljašnje dakriocistorinostomije. Analiza patoloških procesa odgovornih za histopatološki potvrđenu primarnu i sekundarnu opstrukciju odvodnog sistema suza. Analiza relevantnih kliničkih podataka pacijenata sa primarnom i sekundarnom opstrukcijom odvodnog sistema suza. Analiza/upoređivanje dobijenih patohistoloških i relevantnih kliničkih podataka...Disorders of the lacrimal drainage system causing tear outflow obstruction are a common problem in ophthalmology. Blockage in the lacrimal excretory outflow system, when normal tear channeling into the nose is impaired, in the vast majority of cases is at the point of the lacrimal sac and/or lacrimonasal duct, and caused by non-specific or specific pathology that involves the lacrimal sac and/or lacrimonasal duct. The majority of obstructions of the lacrimal excretory outflow system is acquired ones, occuring in adulthood, involving the distal parts of the system. Acquired obstruction can be primary/idiopathic or secondary. In the primary, yet unidentified cause contributes to chronic inflammation of the lacrimal sac, condition called primary chronic dacryocystitis. Different etiological factors (infection, inflammation, trauma, mechanical barriers, toxic effects or neoplasm), some of which are common and others hardly visible, can lead to secondary acquired obstruction of the distal part of a lacrimal drainage system clinically impressive as idiopathic inflammation. Aim Determining the frequency of non-specific and specific primary lacrimal sac pathology as a cause of clinically presumed primary acquired lacrimal drainage system obstruction in a given consecutive samples of incisional biopsies obtained during external dacryocystorhinostomy. Analysis of pathological processes responsible for histopathologically confirmed primary and secondary acquired lacrimal drainage system obstruction. Analysis of relevant clinical data of patients with primary and secondary acquired lacrimal drainage system obstruction. Analysis/comparison of obtained histopathological and relevant clinical data..

Clinical significance of routine lacrimal sac biopsy during dacryocystorhinostomy: A comprehensive review of literature

The main purpose of this paper is to provide the information about the incidence and types of pathology of secondary acquired obstructions of the lacrimal excretory outflow system caused by primary lacrimal sac non-neoplastic and neoplastic lesions. After a thorough literature search, 17 case-control studies were found and selected, data were extracted and categorized, to evaluate specific lacrimal sac pathology mimicking inflammation. A total of 3865 histopathologically examined lacrimal sac wall biopsy specimens from 3662 patients, taken during dacryocystorhinostomy for clinically presumed primary chronic dacryocystitis, were analyzed. The most common reported histopathological finding was non-specific chronic inflammation with or without fibrosis (94.15% of cases). Lacrimal sac-specific pathologies were present in 226 (5.85%) cases. Unsuspected lacrimal sac-specific pathologies were present in 55/226 (24.34%) cases. Almost 45% of primary lacrimal sac malignant neoplasms were not suspected, preoperatively and intraoperatively. Tumor-like lesions of the lacrimal sac were the most common pathology found: (1) lacrimal stones-dacryoliths, (2) pyogenic granuloma, (3) granulation tissues, (4) reactive lymphoid hyperplasia, and (5) lacrimal sac-specific inflammation (Wegener’s granulomatosis and sarcoidosis). Neoplastic pathology was found in 55/3865 (1.42%) lacrimal sac wall biopsy specimens; of those, malignant cases were 2.24 times more frequent than benign. Lymphoma was the most common preoperatively unsuspected or intraoperatively unexpected neoplastic pathology. This analysis of the relevant literature highlights the value of routine lacrimal sac biopsy during surgery for clinically presumed primary acquired nasolacrimal duct obstruction