Stones in the lacrimal gland: a rare condition

Abstract

ABSTRACT.Purpose: Stones (dacryoliths) in the lacrimal drainage system are relatively common. However, stones in the lacrimal gland itself are very rare. We present three cases of lacrimal gland stones and describe the clinical and histopathological characteristics and composition of the stones. Methods: Three patients presented with swelling in the lateral canthal region of several months' duration. Clinical examination in each case revealed a mass adjacent to the lacrimal gland. We carried out surgical excision, histological examination and Raman spectroscopy. Results: Histopathological examination of the excised material showed an eosinophilic, amorphic material organized in lamellae and localized in a ductule. The findings were consistent with a stone in the lacrimal gland in all three cases. All stones were composed of proteins of similar types. After surgery, the three patients healed without complications. Conclusions: Lacrimal gland stones represent a very rare but relevant differential diagnosis when a patient presents with unilateral persistent conjunctivitis or with a tumour in the lateral canthus. Treatment is excision under local anaesthesia.

Dacryoliths in the lacrimal gland ductule

“…The short duration of symptoms, on the other hand, would argue against such a mechanism. Bacteria associated with dacryolithiasis in the lacrimal gland may be more likely to be a secondary phenomenon since short history cases do not show any evidence of bacteria (this study), while microorganisms could primarily be detected in patients with a longer history of symptoms (Halborg et al 2009). …”

“…Twelve cases of dacryoliths in the lacrimal gland have been reported (Naito et al 1973;Duke-Elder 1952;Baker & Bartley 1990;Baratz et al 1991;Mawn et al 1997;Zafar et al 2004;Halborg et al 2009). …”

A huge lacrimal gland ductule dacryolith with a hairy nucleus: a case report

“…Baker and Bartley reported two cases with lacrimal gland ductule stone, and histopathologic examination disclosed an obvious nidus of unknown material in the center of the dacryolith [ 1 ]. Halborg et al reported 3 cases of lacrimal gland stones which were composed of amorphous material organized in lamella and separated by a granular-transitional zone [ 3 ]. Alten et al presented a series of 4 cases with dacryolith, one of which contained amorphous acellular organic material with a cilium surrounded by inflammatory cells [ 4 ].…”

Konkremente des Tränenapparates

“…Entsprechend müssen im Bereich der Tränendrüse mehrere begünstigende Umstände zusammenkommen (Sekretstau, bakterielle Superinfektion etc. ), um die Steinbildung zu ermöglichen 2 , 9 .…”