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Case Reports
. 2023 Feb 21;16(1):148-150.
doi: 10.4103/ojo.ojo_304_21. eCollection 2023 Jan-Apr.

Diffuse large cell lymphoma of the lacrimal sac may mimic as acute dacryocystitis

Soma Rani Roy  1 , Murtuza Nuruddin  2 , Fahmida Hoque  1
Affiliations
Case Reports

Diffuse large cell lymphoma of the lacrimal sac may mimic as acute dacryocystitis

Soma Rani Roy et al. Oman J Ophthalmol. .

Abstract

A 36-year-old male patient presented with a firm swelling in the left lacrimal sac region with a history of recurrent episodes of acute dacryocystitis, which partly resolved with systemic antibiotics. Computed tomography showed diffuse soft tissue mass without bony erosion in the same area. Incisional biopsy confirmed diffuse large cell lymphoma of non-Hodgkin's type by histopathology and immunohistochemistry. Oncologists did not detect systemic involvement, and the patient received six cycles of cyclophosphamide, hydroxydaunorubicin, oncovin, and prednisolone (CHOP). Epiphora was resolved, and no recurrence of the lesion was seen with subsequent dacryocystorhinostomy with intubation and was in good health for up to 3 years of follow-up. Although primary lacrimal sac lymphoma is a rare entity, high suspicion, and prompt action in atypical cases can save lives from aggressive diffuse large cell lymphoma.

Keywords: Acute dacryocystitis; CHOP therapy; dacryocystorhinostomy; diffuse large cell lymphoma.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1:
Figure 1:
Clinical picture. (a) Acute swelling in the lacrimal area. (b) CT showing diffuse lesion in the lacrimal region extending to mid-orbit. (c) After receiving CHOP therapy and DCR operation. CT: Computed tomography, DCR: Dacryocystorhinostomy
Figure 2:
Figure 2:
Histopathological feature. (a) H and E: Diffuse infiltration of atypical centroblast-type lymphoid cells. (b) The atypical centroblast-type lymphoid cells are positive for B-cell marker CD20. In addition, brown is positive membranous staining. (c) STAT6: Immunocytochemistry shows that every tumor cells express the STAT6 protein. Brown is positive staining. CD20: Cluster of differentiate 20, STAT6: Signal transducer and activator of transcription 6
See this image and copyright information in PMC

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