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KMID : 1038920170160030115
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Annals of Optometry and Contact Lens
2017 Volume.16 No. 3 p.115 ~ p.119
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IgG4-related Inflammatory Cyst of Lacrimal Sac
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Park Hye-In
Lee Kang-Won
Chu Young-Chae
Kang Sung-Mo
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Abstract
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Purpose: The aim of this study is to report a case of IgG4-related inflammatory cyst of lacrimal sac.
Case summary: A 40-year-old female complained of left upper eyelid swelling with redness of duration 18 months. Initial her visual acuity was 20/20 (OD), 20/20 (OS). Swelling with an erythematous lesion was found on the left upper eyelid and an erythematous palpable mass was present at the left medial caruncle. The exophthalmometry exam revealed proptosis of 2.0 mm on the left eye. Computed tomography (CT) depicted a 1.0 × 1.6 × 2.4 cm sized cystic mass on the lacrimal sac extending to the left medial canthus. The patient underwent endoscopic biopsy and dacryocystorhinostomy with silicone tube intubation, and during the surgery, a whitish yellow mucoid discharge drained from the lacrimal sac, which was dense lymphoplasmacytic infiltrates with H&E staining, and many IgG- and IgG4-positive plasma cells were observed in high power fields during anti-IgG and anti-IgG4 antibody examinations. After procedure, orbital mass decreased on CT. After obtaining the pathologic result, serum IgG4 was normal at 68.3 mg/dL (normal range 3.9-86.4 mg/dL) and serum IgG was also normal as 1,285 mg/dL (normal range 870-1,700 mg/dL). The erythrocyte sedimentation rate was 8 mm/hour.
Conclusion: We obtained the pathologic results of lymphoplasmacytic infiltrates and many IgG- and IgG4-positive plasma cells in lacrimal sac, and this case showed IgG4-related disease involved a lacrimal sac and created an inflammatory cyst in the sac initially in Republic of Korea.
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KEYWORD
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Lacrimal sac, IgG4-related disease
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