Journal of Infectious Diseases & Therapy
Open Access

Abstract

14-year-old boy was referred to King Khaled Eye Specialist Hospital as case of left nasolacrimal duct obstruction for Dacryocystorhinostomy. The child complained of left eye tearing for one year duration followed by localized swelling over the medial canthal for one month duration. The mas firm with bony consistency and caused no proptosis. The lacrimal system was clearly obstructed and the probe could not be passed. The patient then underwent CT scan which highlighted a well-defined 8.2 x 13.1 mm lesion filling the left nasolacrimal sac with extension inferiorly into a dilated nasolacrimal duct. The left nasolacrimal duct measured 7 mm in diameter while the right unaffected side measured 4.5 mm. Surgical exploration was carried out revealing a gelatinous fleshy mass filling the entire lacrimal sac and incisional biopsy was taken. The biopsy revealed a lacrimal sac lymphoma. The lacrimal sac is lined by a pseudostratified columnar epithelium with cilia and goblet cells. Lacrimal sac tumors are divided into epithelial and non-epithelial tumors based on the tumor origin. 60-94% of lacrimal sac tumors are classified under epithelial tumors. Benign epithelial tumors include Papillomas which are the most common comprising 36%, oncocytomas and adenomas. Malignant epithelial tumors in the lacrimal sac are squamous cell carcinomas, oncocytic adenocarcinoma, mucoepidermoid carcinoma and cystic adenoid carcinoma. Inverted papillomas may be considered premalignant lesions and they are associated with human papilloma virus 6 and 18 alongside with squamous cell carcinoma. Lacrimal sac lymphomas are categorized as lymphoproliferative non epithelial malignant tumors of the lacrimal sac. They are rare with a median age of onset at 51 years. Most common type is mucosa-associated lymphoid tissue (MALT) or diffuse large B cell lymphoma (DLBCL). Lacrimal sac lymphoma in pediatric age group is very rare. In a review of 250 pediatric patients with orbital tumors in YEAR by Shields et al, only 6 cases had orbital lymphoma none of which were within the lacrimal sac. Few cases have been reported in the literature after this review was published.

Biography

Dalal R Fatani is an aspiring ophthalmologist aiming to continue my career growth and further expand my knowledge, surgical skills, and research contributions in the field. She is member of the king Saud medical city training unit to promote resident’s wellbeing and facilitate their journey. She is Producer and host of an educational podcast directed towards ophthalmology residents. Certified Suba diving (advanced level diver), Mountain climbing (local hiking excursions, Mount Kilimanjaro for Animal rights and welfare, Mount Shams in Oman for GCC fitness), Animal rescue activities with Open Paws Riyadh, and Reading (self-improvement and parenting books).