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Obstruction of the Nasolacrimal System due to B-cell-lymphoma, A Case Report

1Uhlig C. E., 1Hackethal U., 2Herbst H., 1Busse H.,
1Westfälische Wilhelms-Universität Münster, Klinik und Poliklinik für Augenheilkunde (Münster)
2Westfälische Wilhelms-Universität Münster, Gerhardt-Domagk-Institut für Pathologie (Münster)

Purpose: Dacryocystitis or epiphora are seldom occuring as a result of tumors of the nasolacrimal system. We report on a 65-year-old woman who has suffered for six months of a subcutaneous flabby and growing mass (7 x 7 mm) in the region of her left nasolacrimal system with additional epiphora but without signs of infection. Her general anamnesis was an increased level of gammaglutamyltransferase and an ancient gastric ulcer due to helicobacter pylori.
Method: Contrast roentgenogram of the nasolacrimal system, probing and lacrimal outflow irrigation, endoscopic examination with biopsy in general anaesthesia.
Results: Saline syringed through the inferior or superior lid puncture resulted in regurgitation of fluid from the canaliculus that was not irrigated. Saline could not be syringed into the nose. Dacryocystogram demonstrated a stop of the common canaliculus. In general anaesthesia it was possible to probe the complete nasolacrimal system with endoscopic means while the tumour in the lacrimal sac did not change in size. Biopsy demon-strated a low malignant B-cell-lymphoma.
Conclusions: Lymphomas may cause dacryostenosis without signs of infection or reduced general health. Endoscopic examination and biopsy helps to specify the type and dignity of tissue to treat the patient efficiently.