Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Jan;6(3):191-4.
doi: 10.2500/ar.2015.6.0130.

Nasolacrimal duct obstruction caused by lymphoproliferative infiltration in the course of chronic lymphocytic leukemia

Ralph Litschel  1 , Marco Siano, Abel-Jan Tasman, Sergio Cogliatti
Affiliations

Nasolacrimal duct obstruction caused by lymphoproliferative infiltration in the course of chronic lymphocytic leukemia

Ralph Litschel et al. Allergy Rhinol (Providence). 2015 Jan.

Abstract

Background: Endoscopic dacryocystorhinostomy (DCR) is the standard treatment of nasolacrimal duct obstruction. Only in rare cases, blockage may be caused by malignant tumors and even more exceptionally by lymphatic neoplasms so that biopsies are not routinely taken for diagnostic purposes.

Methods: A computerized retrieval system was used for this retrospective study to identify all patients with histologically documented lymphoproliferative infiltration in the lacrimal drainage system from 2001 to 2009.

Results: In four of 191 patients (2.1%), infiltration of the nasolacrimal sac mucosa with a small lymphocytic lymphoma (SLL)/chronic lymphatic leukemia (CLL) was found. Patients who develop symptoms like epiphora within the course of known CLL are highly suspicious for lymphoproliferative infiltration of the lacrimal drainage associated lymphoid tissue.

Conclusion: A proactive approach with ophthalmologic consultation and DCR should be followed in these patients to avoid dacryocystitis.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest to declare pertaining to this article

Figures

Figure 1.
Figure 1.
(A) Giemsa stain: overview with diffuse small lymphocytic mucosal infiltration without lymphoepithelial lesions. Inlet: Lymphoproliferation dominated by small lymphocytes, intermingled with prolymphocytes and paraimmunoblasts. (B) Dim positivity for CD20. (C) and (D) Strong positivity for CD5 and CD23.
Figure 2.
Figure 2.
Swelling, redness and left canthal mass in patient 4.
See this image and copyright information in PMC

References

    1. Sjo LD, Ralfkiaer E, Juhl BR, et al. Primary lymphoma of the lacrimal sac: An EORTC ophthalmic oncology task force study. Br J Ophthalmol 90:1004–1009, 2006. - PMC - PubMed
    1. Ferry JA, Fung CY, Zukerberg L, et al. Lymphoma of the ocular adnexa: A study of 353 cases. Am J Surg Pathol 31:170–184, 2007. - PubMed
    1. Venkitaraman R, George MK. Primary non Hodgkin's lymphoma of the lacrimal sac. World J Surg Oncol 5:127, 2007. - PMC - PubMed
    1. Yip CC, Bartley GB, Habermann TM, Garrity JA. Involvement of the lacrimal drainage system by leukemia or lymphoma. Ophthal Plast Reconstr Surg 18:242–246, 2002. - PubMed
    1. Hatt M. Surgery of acquired canalicular stenosis. Orbit 11:153–156, 1992.

LinkOut - more resources