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. 2013 Dec 18;6(6):817-26.
doi: 10.3980/j.issn.2222-3959.2013.06.14. eCollection 2013.

Pathological, immunohistochemical and microbiologicalal analysis of lacrimal sac biopsies in patients with chronic dacrocystitis

Rowayda Mahmoud Amin  1 , Faten Aly Hussein  1 , Hisham Farouk Idriss  1 , Nesrine Fathy Hanafy  2 , Dina Mohamed Abdallah  3
Affiliations

Pathological, immunohistochemical and microbiologicalal analysis of lacrimal sac biopsies in patients with chronic dacrocystitis

Rowayda Mahmoud Amin et al. Int J Ophthalmol. .

Abstract

Aim: To analyze cases of obstruction of the nasolacrimal duct which creates a fertile environment for secondary bacterial infection and can result in dacryocystitis, which is a constant threat to cornea and orbital soft tissue and a potential source of endophthalmitis following intraocular surgery. The majority of obstructions of the lacrimal excretory outflow system are acquired ones occurring in adulthood and involving the distal parts of the system. Acquired obstruction may be primary/idiopathic or secondary to a wide variety of infectious, inflammatory, traumatic, mechanical, toxic or neoplastic causes mimicking idiopathic inflammation. These cases are treated by dacryocystorhinostomy (DCR).

Methods: The present study was conducted to determine the histopathologic, immunohistochemical and current microbiologic characteristics of lacrimal sac specimens in patients undergoing external dacryocystorhinostomy.

Results: Non-specific lacrimal sac pathology was present in all 33 cases and 81.8% of the cases showed moderate chronic inflammation with a chronic inflammatory score (CIS) ranging between 4 and 6, whereas 12.12% showed severe inflammatory changes with a CIS of 7. Mild degree of inflammation was seen in 6.06% with a CIS of 3. The total prevalence of gram-positive, gram-negative, and culture-negative samples were 59.4%, 37.5%, and 3% respectively.

Conclusion: Non-specific chronic inflammation with fibrosis is indeed the most commonly reported histopathological finding in lacrimal sac wall biopsy specimens.

Keywords: chronic inflammation; dacrocystitis; lacrimal duct obstruction; lacrimal sac biopsy.

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Figures

Figure 1
Figure 1. Mild lymphocytic infiltration and mild angiogenesis. H&E ×100
Figure 2
Figure 2. Intact linning with moderate inflammation. H&E ×100
Figure 3
Figure 3. Severe lymphocytic infiltrate and fibrosis. H&E ×100
Figure 4
Figure 4. Moderate angiogenesis. H&E ×100
Figure 5
Figure 5. CD3 positive membranous immunostaining in the lymphocytic infiltrate.
Figure 6
Figure 6. Bacteriological findings from the culture of lacrimal sac biopsy specimens obtained from 33 patients undergoing dacryocystorhinostomy for nasolacrimal duct obstruction.
See this image and copyright information in PMC

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