Primary non Hodgkin's lymphoma of the lacrimal sac
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BioMed Central
Open Access
Case report
Primary non Hodgkin's lymphoma of the lacrimal sac Ramachandran Venkitaraman1 and Mathew K George*2 Address: 1Division of Clinical Oncology, Royal Marsden Hospital, Sutton, Surrey, SM2 5PT, UK and 2Division of Medical Oncology, Royal Darwin Hospital, Casuarina, Australia Email: Ramachandran Venkitaraman - [email protected]; Mathew K George* - [email protected] * Corresponding author
Published: 6 November 2007 World Journal of Surgical Oncology 2007, 5:127
doi:10.1186/1477-7819-5-127
Received: 21 March 2007 Accepted: 6 November 2007
This article is available from: http://www.wjso.com/content/5/1/127 © 2007 Venkitaraman and George; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: Primary Non Hodgkin's Lymphoma (NHL) of the lacrimal sac is rare. Methods: The clinical features of a 78 year old female who presented with epiphora and swelling of the left lacrimal sac are described. Results: Computerised tomography showed a mass involving the left lacrimal sac. Histopathological examination revealed a diffuse large B cell NHL. Immunohistological examination demonstrated B cell origin. Chemotherapy could not be administered due to co morbid conditions. The patient was treated with radiotherapy to a dose of 45 Gy in 25 fractions. Patient is disease free and on follow up after 36 months. Conclusion: Primary radiotherapy is a treatment option with curative potential for localized NHL of the lacrimal sac and may be considered in patients who cannot tolerate appropriate chemotherapy.
Background Tumors involving the nasolacrimal drainage system are rare and more than 90% of these tumours are of epithelial origin [1]. Majority of lymphomas involving the lacrimal sac are secondary to systemic lymphoreticular malignancy [1]. Primary non Hodgkin's lymphoma (NHL) of the lacrimal sac is a rare neoplasm [2-6]. Therefore, the clinicopathological features and optimal management of primary lacrimal sac NHL are not well characterized. In this report, we present the clinical features of a patient with primary NHL of the lacrimal sac treated successfully with radiotherapy.
Case presentation A 78 year old female patient presented with epiphora of the left eye of 6 months duration and a painless swelling
of the left lacrimal sac area of 2 months duration. Physical examination showed a firm, non-tender mass measuring 3 × 4 cm in the right lacrimal fossa. Irrigation test revealed complete obstruction of the lacrimal drainage system. Rest of the eye and adnexae were normal. Computerised tomography (CT) scan of the orbit showed a heterogeneous soft tissue mass arising from the lacrimal sac, infiltrating and pushing the globe laterally and forward, causing exophthalmos with no bony erosion (figure 1). There w
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