Linberg J V, McCormick S A
Ophthalmology. 1986 Aug;93(8):1055-63. doi: 10.1016/s0161-6420(86)33620-0.
Primary acquired nasolacrimal duct obstruction (PANDO) of adults is a clinical syndrome of unknown cause, and the histopathology of the nasolacrimal duct has not been substantially studied. A technique of excisional biopsy of the soft tissue contents within the nasolacrimal canal during external dacryocystorhinostomy (DCR) is presented. No complications were associated with the biopsy technique in 14 cases. Two cases of lacrimal obstruction secondary to sarcoidosis and leukemia were discovered in biopsies of patients with the clinical syndrome of PANDO, demonstrating the value of routine biopsy during DCR. Biopsies revealed a spectrum of changes that correlated with duration of symptoms. Early cases revealed active chronic inflammation along the entire length of the narrowed nasolacrimal duct. Intermediate cases revealed focal resolution of the inflammatory process with fibrosis, while late cases showed fibrous obliteration of the entire duct. Although the first event in primary acquired nasolacrimal duct obstruction remains uncertain, clinicopathologic correlation suggests that compression of the duct by inflammatory infiltrates and edema precedes clinical chronic dacryocystitis.
成人原发性获得性鼻泪管阻塞（PANDO）是一种病因不明的临床综合征，鼻泪管的组织病理学尚未得到充分研究。本文介绍了一种在外部泪囊鼻腔吻合术（DCR）期间对鼻泪管内软组织内容物进行切除活检的技术。14例患者采用该活检技术均未出现并发症。在具有PANDO临床综合征的患者活检中发现2例继发于结节病和白血病的泪道阻塞，证明了DCR期间常规活检的价值。活检显示了一系列与症状持续时间相关的变化。早期病例显示狭窄鼻泪管全长有活跃的慢性炎症。中期病例显示炎症过程局灶性消退并伴有纤维化，而晚期病例则显示整个管道纤维性闭塞。虽然原发性获得性鼻泪管阻塞的首发事件仍不确定，但临床病理相关性表明，炎症浸润和水肿对管道的压迫先于临床慢性泪囊炎出现。
