DACRYOCYSTITIS ASSOCIATED WITH MALIGNANT-LYMPHOMA OF THE LACRIMAL SAC

Background: Tumors of the lacrimal sac are unusual, and lymphomas of t he lacrimal sac are quite rare. Four patients with a history of well-d ifferentiated, small cell lymphoma or chronic lymphocytic leukemia pre sented with either acute or chronic dacryocystitis and epiphora due to lymphomatous infiltration of the lacrimal sac. Methods: All four pati ents underwent dacryocystorhinostomy with lacrimal sac biopsy. All tis sues underwent complete histopathologic evaluation including immunohis tochemical studies for cell surface markers and, in addition, were com pared with previous biopsies performed for the initial diagnosis of ly mphoma. Findings: All biopsies demonstrated small cell well-differenti ated lymphoma on histologic and immunofluorescent examination. No pati ent demonstrated orbital involvement on computed tomography. One patie nt had previously diagnosed chronic lymphocytic leukemia and one patie nt demonstrated diffuse lymph node involvement on postoperative system ic evaluation. All four patients underwent additional chemotherapy. No recurrence of dacryocystitis or epiphora occurred. Conclusion: Four p atients presented with dacryocystitis secondary to lacrimal sac lympho ma. Lymphomatous lacrimal sac infiltration is an unusual cause of dacr yocystitis. Biopsy of the lacrimal sac plays a diagnostically importan t role in dacryocystorhinostomy even in the absence of obvious tumorou s involvement of the lacrimal sac mucosa.