Heindl L M, Treutlein E, Jünemann A G M, Kruse F E, Holbach L M
Augenklinik mit Poliklinik, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schwabachanlage 6, Erlangen, Germany.
Ophthalmologe. 2010 Dec;107(12):1139-44. doi: 10.1007/s00347-010-2200-1.
Tumors of the lacrimal drainage system are rare but potentially life-threatening. The purpose of this study was to investigate the applicability of selective lacrimal sac biopsy in 500 cases of external dacryocystorhinostomy for acquired dacryostenosis.
Lacrimal sac biopsy was obtained selectively for atypical clinical and/or intraoperative findings. The frequency and spectrum of biopsies were recorded and correlated with the follow-up results.
Lacrimal sac biopsy was performed in 19 external dacryocystorhinostomies (3.8%) including non-Hodgkin B-cell lymphoma (3), squamous carcinoma (2), mucoepidermoid carcinoma (1), malignant melanoma (1), oncocytoma (1), pyogenic granuloma (4), Wegener's granulomatosis (4) and sarcoidosis (3). Within 5 years none of the patients without biopsy developed systemic inflammatory diseases or lacrimal neoplasms. The 5-year survival was 87% in patients with significant lacrimal sac pathology and 96% in patients without significant pathology.
External dacryocystorhinostomy with selective biopsy for atypical clinical and intraoperative findings allows safe diagnosis and management of potentially life-threatening lacrimal lesions.
泪道系统肿瘤罕见，但可能危及生命。本研究旨在探讨选择性泪囊活检在500例因后天性泪道狭窄而行外路泪囊鼻腔吻合术患者中的适用性。
对于非典型临床和/或术中发现，选择性获取泪囊活检样本。记录活检的频率和范围，并与随访结果相关联。
在19例（3.8%）外路泪囊鼻腔吻合术中进行了泪囊活检，包括非霍奇金B细胞淋巴瘤（3例）、鳞状细胞癌（2例）、黏液表皮样癌（1例）、恶性黑色素瘤（1例）、嗜酸细胞瘤（1例）、化脓性肉芽肿（4例）、韦格纳肉芽肿（4例）和结节病（3例）。在5年内，未进行活检的患者均未发生全身性炎性疾病或泪道肿瘤。泪囊有明显病变的患者5年生存率为87%，无明显病变的患者为96%。
对于非典型临床和术中发现进行选择性活检的外路泪囊鼻腔吻合术，可安全诊断和处理可能危及生命的泪道病变。
