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Case Reports
. 2010 Nov 23:4:1351-4.
doi: 10.2147/OPTH.S14675.

Case of primary diffuse large B-cell lymphoma of lacrimal sac in a Japanese patient

Fusae Kajita  1 , Toshiyuki Oshitari, Jiro Yotsukura, Kaoru Asanagi, Takayuki Baba, Takashi Kishimoto, Shuichi Yamamoto
Affiliations
Case Reports

Case of primary diffuse large B-cell lymphoma of lacrimal sac in a Japanese patient

Fusae Kajita et al. Clin Ophthalmol. .

Abstract

The purpose of this study was to determine the characteristics of primary diffuse large B-cell lymphoma (DLBCL) of the lacrimal sac. A 77-year-old man had epiphora of the right eye for three years. After visiting five clinics and hospitals, he was referred to our hospital, and the preoperative magnetic resonance imaging findings suggested a lacrimal sac mass. Dacryocysteography showed an obstruction of the right nasolacrimal duct, so we performed dacryocystectomy. After a histopathologic examination of the specimen, the patient was diagnosed with a DLBCL. Positron emission tomography scanning excluded metastases, and the final diagnosis was made of a primary DLBCL of the right lacrimal sac. He underwent radiotherapy with 30.6 Gray in total to the right lacrimal sac. After radiotherapy, no recurrence has been observed anywhere in his body for one year. Although a malignant lymphoma of the lacrimal sac is rare, clinicians should consider a primary malignant lymphoma in the differential diagnosis in patients with chronic dacryocystitis.

Keywords: Japanese; dacryocystectomy; diffuse large B-cell lymphoma; lacrimal sac; radiotherapy.

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Figures

Figure 1
Figure 1
Preoperative MRI and dacryocysteographic findings in a 77-year-old patient. Both magnetic resonance imaging examinations of T1 images (A, B) and T2 image (C) show a low or isointensity mass in the right lacrimal sac without invasion of surrounding tissues, which is consistent with histopathologic examination; the adjacent epithelium was not invaded by lymphoma cells. Dacryocysteography shows an obstruction of the right nasolacrimal duct (D, E).
Figure 2
Figure 2
Representative histopathologic findings of frozen section (A) and histopathologic findings in the surgical specimen of the right lacrimal sac tumor (B–F). Diffuse proliferation of atypical lymphoid cells can be seen. Atypical nuclei with prominent nuclei are present, which suggest a malignant tumor including malignant lymphoma A. Hematoxylin and eosin staining showed large lymphoid cells with high-density nuclei (B). Immunostaining with L26 C and CD79a (D) are strongly positive, and CD10 (E) is weakly positive on the membrane of lymphoid cells. The adjacent epithelium was not invaded by lymphoma cells (cytokeratin, CAM5.2, (F)).
See this image and copyright information in PMC

References

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