Apocrine secretion in lacrimal gland cysts (dacryops): a common but underrecognized phenomenon

Abstract

We present six cases (five females, one male; aged 26-81 years) of dacryops, also known as lacrimal gland cyst, all of which occurred at the outer canthal area below the upper eyelid. All presented clinically as a painless cystic lesion that was white to blue in color. Microscopically, in addition to typical features of dacryops, which is characterized by a partially cystic proliferation that includes a double layer of columnar to cuboidal epithelial cells associated with lobules of lacrimal gland tissue, we identified evidence of apocrine secretion (i.e. apical snouts projecting into the lumen), either in the cystic component of the proliferation or in contiguous lacrimal duct, in all cases. One example was unusual. It manifested, in addition to typical cyst formation, with areas of ductal and probably acinar hyperplasia. We conclude that apocrine secretion in dacryops is a common and underrecognized phenomenon. Dacryops should be distinguished from apocrine hidrocystoma, a lesion commonly encountered in the periorbital area in the practice of dermatopathology.

Dacryops with extensive lacrimal and maxillary bone defects in four dogs

“…The morphological features revealed by histopathological examination supported the diagnosis of a dacryops. A partially cystic proliferation and a cystic structure surrounded by an attenuated epithelium consisting of a double layer of cuboidal epithelial cells, 18,19 characteristic of the excretory duct associated with lobules of lacrimal gland tissue clearly suggest cyst formation from a glandular excretory duct and/or glandular tissue.…”

Lacrimal ductal cyst of the medial orbit: a case report

“…It has been reported associated with trachoma, conjunctival inflammation, ocular cicatricial pemphigoid, high levels of IgA, prolapse of the lacrimal gland, ocular trauma and chemical injury [ 11 , 15 , 18 ]. Initial reports proposed mechanical blockage theory and impaired ductal myoepithelial contractility, others proposed that a combination of periductal inflammation and trauma and a dysfunction of the rich neural plexus and hypersecretion may cause cyst formation [ 12 , 19 , 20 ]. The findings of apocrine changes, lymphoid tissue and lachrymation in this case may help to explain the pathogenesis of the disease.…”

Dacryops of the Third Eyelid in a cat

“…Inflammation or trauma of periductal or conjunctival tissue could cause lacrimal gland hypersecretion and duct wall damage. The ducts may then become obstructed and dilate to eventually form a cyst . Other possible causes of cyst formation include congenital malformation and neoplasia .…”

“…Dacryops is a lacrimal cyst that forms in any lacrimal gland, and which contains apocrine secretions . Several reports of dacryops in dogs are available as well as one report in a red‐eared slider turtle .…”