Alkatan Hind, Al-Qurashi Majed
Ophthalmology Department, King Saud University College of Medicine, Riyadh, Saudi Arabia; Department of Pathology & Laboratory Medicine, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
Retina Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
Can J Ophthalmol. 2017 Feb;52(1):34-41. doi: 10.1016/j.jcjo.2016.08.004. Epub 2016 Nov 17.
Limited literature documenting the incidence of unsuspected malignant neoplasm among dacryocystorhinostomy/Dacryocystectomy (DCR/DCT) specimens is reviewed to determine if routine biopsy of all the patients undergoing such procedures is required. We are evaluating if sending lacrimal sac specimens for histopathological examination is necessary as a routine patient's care standard.
This is a retrospective study of all lacrimal sac specimens received for histopathological examination in a tertiary eye hospital over a period of 12 years.
This is an institutional study of all patients who underwent lacrimal sac drainage procedure and/or lacrimal sac biopsy during the 12-years period.
498 samples from 459 patients were included for review of the histopathological findings and tissue diagnosis. The files were checked for demographic data collection, preoperative clinical diagnosis and suspicion of malignancy.
Out of the 459 patients initially included, the mean age was 51.63 ± 17.8 years. Female patients constituted 70.8% while male patients accounted for 29.2%. Malignancy was suspected before surgery in 3 cases of the 498 specimens reviewed (0.6%). The remaining 495 specimens analyzed, 17 cases (3.43%) had unsuspected tissue diagnosis (other than chronic dacryocystitis) including Oncocytoma in 7, dacryolith in 7 and granulomas in 3. However, no case of malignant neoplasm was identified.
There were no unsuspected malignant cases in the current series. Therefore routine histopathological examination of DCR specimens is not considered to be essential. It should be reserved only for selected suspicious cases. Careful intra-operative assessment in these cases is also warranted.
回顾关于泪囊鼻腔吻合术/泪囊切除术（DCR/DCT）标本中未被怀疑的恶性肿瘤发生率的有限文献，以确定是否需要对所有接受此类手术的患者进行常规活检。我们正在评估将泪囊标本送检进行组织病理学检查作为常规患者护理标准是否必要。
这是一项对一家三级眼科医院在12年期间接收的所有用于组织病理学检查的泪囊标本的回顾性研究。
这是一项针对在12年期间接受泪囊引流手术和/或泪囊活检的所有患者的机构研究。
纳入459例患者的498份样本，以回顾组织病理学检查结果和组织诊断。检查文件以收集人口统计学数据、术前临床诊断和恶性肿瘤怀疑情况。
在最初纳入的459例患者中，平均年龄为51.63±17.8岁。女性患者占70.8%，男性患者占29.2%。在审查的498份标本中，有3例（0.6%）在手术前被怀疑患有恶性肿瘤。在分析的其余495份标本中，17例（3.43%）有未被怀疑的组织诊断（除慢性泪囊炎外），包括7例嗜酸细胞瘤、7例泪石和3例肉芽肿。然而，未发现恶性肿瘤病例。
本系列中没有未被怀疑的恶性病例。因此，DCR标本的常规组织病理学检查不被认为是必不可少的。它应仅保留用于选定的可疑病例。在这些病例中进行仔细的术中评估也是必要的。
