Ishikawa Eri, Takahashi Yasuhiro, Nishimura Kunihiro, Ito Makoto, Kakizaki Hirohiko
Department of Oculoplastic, Orbital, and Lacrimal Surgery, Aichi Medical University Hospital.
Department of Otolaryngology.
J Craniofac Surg. 2019 Jan;30(1):e52-e54. doi: 10.1097/SCS.0000000000004971.
Sarcoidosis rarely develops in the lacrimal sac. Lacrimal sac sarcoidosis may be associated with sarcoidosis-related rhinosinusitis. The anatomical and histological relationship between the lacrimal drainage system and nasal mucosa has been indicated as a predisposing factor for this concomitance. However, the characteristics of this condition are not fully understood. Herein, the authors report a case where dacryocystitis and rhinosinusitis developed secondary to sarcoidosis. Pathological examination of the lacrimal sac wall revealed noncaseating epithelioid granulomas in the subepithelial layer, which contains the lacrimal-drainage-associated lymphoid tissue. The lacrimal-drainage-associated lymphoid tissue comprises the main immune mechanism of the lacrimal system and forms a functional unit with the lacrimal gland, conjunctiva, and nasal mucosa to maintain ocular surface integrity through lymphocyte recirculation. Because sarcoidosis is an autoimmune disorder, this lymphocyte recirculation may be associated with the concurrent nasal lesions in the authors' case.
结节病很少累及泪囊。泪囊结节病可能与结节病相关性鼻旁窦炎有关。泪液引流系统与鼻黏膜之间的解剖学和组织学关系被认为是这种伴发情况的一个易感因素。然而，这种疾病的特征尚未完全明确。在此，作者报告1例继发于结节病的泪囊炎和鼻旁窦炎病例。泪囊壁的病理检查显示上皮下层存在非干酪样上皮样肉芽肿，该层包含与泪液引流相关的淋巴组织。与泪液引流相关的淋巴组织构成泪液系统的主要免疫机制，并与泪腺、结膜和鼻黏膜形成一个功能单位，通过淋巴细胞再循环维持眼表完整性。由于结节病是一种自身免疫性疾病，这种淋巴细胞再循环可能与作者所报道病例中的并发鼻部病变有关。
