Halborg Jakob, Prause Jan Ulrik, Toft Peter Bjerre, Skjødt Karen, Tommerup Niels Rath, Nielsen Ole Faurskov, Heegaard Steffen
Department of Eye Pathology, Institute of Neuroscience and Pharmacology, University of Copenhagen, Copenhagen, Denmark.
Acta Ophthalmol. 2009 Sep;87(6):672-5. doi: 10.1111/j.1755-3768.2008.01301.x. Epub 2009 Aug 11.
Stones (dacryoliths) in the lacrimal drainage system are relatively common. However, stones in the lacrimal gland itself are very rare. We present three cases of lacrimal gland stones and describe the clinical and histopathological characteristics and composition of the stones.
Three patients presented with swelling in the lateral canthal region of several months' duration. Clinical examination in each case revealed a mass adjacent to the lacrimal gland. We carried out surgical excision, histological examination and Raman spectroscopy.
Histopathological examination of the excised material showed an eosinophilic, amorphic material organized in lamellae and localized in a ductule. The findings were consistent with a stone in the lacrimal gland in all three cases. All stones were composed of proteins of similar types. After surgery, the three patients healed without complications.
Lacrimal gland stones represent a very rare but relevant differential diagnosis when a patient presents with unilateral persistent conjunctivitis or with a tumour in the lateral canthus. Treatment is excision under local anaesthesia.
泪道系统中的结石(泪石)较为常见。然而,泪腺本身的结石非常罕见。我们报告3例泪腺结石病例,并描述结石的临床、组织病理学特征及成分。
3例患者均有持续数月的外眦部肿胀。每例临床检查均发现泪腺附近有肿物。我们进行了手术切除、组织学检查及拉曼光谱分析。
切除组织的组织病理学检查显示,有嗜酸性、无定形物质呈层状排列并位于小导管内。所有3例的检查结果均符合泪腺结石。所有结石均由相似类型的蛋白质组成。术后,3例患者均愈合良好,无并发症。
当患者出现单侧持续性结膜炎或外眦部肿物时,泪腺结石是一种非常罕见但需要鉴别的诊断。治疗方法是局部麻醉下切除。