Purpose:

To investigate the histopathologic findings of lacrimal sac specimens obtained during external dakriyosistorinostomi (DCR).

Material-Methods:

Lacrimal sac specimens taken from the posterior sap of 59 patients' 62 sacs undergoing external DCR with U sap technique between April 2004 and May 2006 were examined. Preoperative clinical diagnosis was primary aquired nasolacrimal duct obstruction (PANDO) in 57 patients, seconder nasolacrimal duct obstruction (SNDO) in 2 patients. The clinical features of the patients with abnormal histopathological results were reviewed retrospectively to determine if the pathology was suspected before or at the time of the surgery.

Results:

The most common histopathologic findings in lacrimal sacs were chronic nonspesific inflammation (n: 54, 87.09%), fibrosis (n: 17, 27.41%), dystrophic calcification (n: 14, 22.58%). Less common findings were granulation tissue (n: 9, 14.51%), hyaline connective tissue (n: 3, 4.83%), capiller vascular proliferation (n: 2, 3.22%), fibroblastic proliferation (n: 1, 1.61%), dissociated epithelial cells (n: 1, 1.61%), and in one patient lymphoma was detected (1.61%). In total 1 (1.61%) sac demostrated significant pathology. Clinical suspicion was persent in 2 patients before surgery.

Conclusion:

Chronic nonspesific inflammation and fibrosis is the most histopatholgy in lacrimal sac specimens obtained during DCR.Lacrimal sac neoplasm was detected in 1.61% of cases and was suspected clinically in 3.22% of cases. In conclusion rutine lacrimal sac biopsy is unnecessary, it should be performed in suspicious cases.

Keywords: Dacryocystorh›nostomy, lacrimal sac, histopathology