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Review of 268 lacrimal gland biopsies in an A ustralian cohort
Author(s) -
Andrew Nicholas H,
McNab Alan A,
Selva Dinesh
Publication year - 2014
Publication title -
clinical and experimental ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.3
H-Index - 74
eISSN - 1442-9071
pISSN - 1442-6404
DOI - 10.1111/ceo.12371
Subject(s) - lacrimal gland , dacryoadenitis , medicine , biopsy , pathology , pleomorphic adenoma , dacryocystitis , sarcoidosis , retrospective cohort study , cohort , salivary gland , surgery
Abstract Background To review the distribution of pathology in lacrimal gland biopsies performed in an A ustralian cohort. Design Retrospective review. Participants Two hundred sixty‐eight lacrimal gland biopsies from 263 patients. Methods Pathology archives in S outh A ustralia and V ictoria were searched for lacrimal gland biopsies performed between 1 J anuary 1997 and 31 D ecember 2012. Data retrieved included the year of biopsy, the histopathological diagnosis, patient age and gender. Main Outcome Measures Distribution of pathology affecting the lacrimal gland; patient age and gender. Results The distribution of lacrimal gland pathology was: inflammations and vasculitides 50.0%, lymphomas 19.8%, lymphoid hyperplasias 12.3%, benign epithelial tumours 7.8% (all pleomorphic adenomas), malignant epithelial tumours 4.1%, dacryops 3.0% and miscellaneous 3.0%. The mean age was 52 years, with lymphoma affecting the oldest patient group (64.6 years) and sarcoidosis the youngest (40.6 years). Of the patients with biopsy‐confirmed dacryoadenitis, biopsy revealed a specific diagnosis in 34% of cases. Immunoglobulin G 4‐related disease was the most common ‘specific’ dacryoadenitis. Significantly more pleomorphic adenomas were diagnosed in the period 1997–2004 than the period 2005–2012 inclusive, but there were no other significant changes in the distribution of pathology over time. Conclusions Two thirds of dacryoadenitis was ‘non‐specific’, two thirds of epithelial tumours were pleomorphic adenomas and approximately two thirds of all lacrimal gland biopsies were accounted for by inflammations and lymphoid hyperplasias. The ratio of inflammations to neoplasias will be significantly influenced by the clinician's threshold for biopsying patients presenting with features of dacryoadenitis.