|Year : 1967 | Volume
| Issue : 3 | Page : 105-106
Non-specific intra-canalicular granuloma
K Nath, HV Nema, S Hameed
Muslim University Institute of Ophthalmology and Gandhi Eve Hospital, Aligarh, India
|Date of Web Publication||21-Jan-2008|
Muslim University Institute of Ophthalmology and Gandhi Eve Hospital, Aligarh
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Nath K, Nema H V, Hameed S. Non-specific intra-canalicular granuloma. Indian J Ophthalmol 1967;15:105-6
Canalicular granulomas are rather rare and occur following trauma, retained foreign bodies, trachoma and mycotic infections. Serra (1926), Scheerer (1931), Baquis (1931), Fazakas (1937), Nicholls (1938) and Redi (1947) have reported cases of nonspecific granulomas while Wegner (1926) reported a case of mycotic granuloma. The other reported solid swelling of the canaliculus is an angioma---Scheerer, (1931).
| Case Report|| |
A muslim female [Figure - 1] aged 80, who had gradually lost her vision over a period of twelve years and was completely blind for the last two years, was complaining of chronic irritation and swelling on the inner side of her right upper lid for the last six months. Incidentally she had been operated upon by a quack two years earlier for blindness in both the eyes but without any benefit.
| Examination|| |
Both eyes had Trachoma IV and chronic blepharo-conjunctivitis. There was a firm pea-size swelling in the region of the right upper canaliculus occupying the medial one quarter of the upper lid [Figure - 1]. Lacrimal passages of this eye were blocked while those of the left were patent. Incidentally, optical iridectomies had been performed in both the eyes previously. Anterior chambers were shallow and hyper-mature cataract was present in both eyes. Tension was raised to 40 mm of Hg and the eyes had lost all perception of light.
| Investigations|| |
All pathological tests were negative. Culture did not show any fungus infection or pathological micro-organisms.
| Treatment|| |
As the glaucoma was painless and there was only a moderate rise of tension, no surgical attempt was made for lowering the tension. The swelling in the region of her right canaliculus was dissected and removed along with the sac. The sac was found to be shrunken and fibrosed [Figure - 2]. The canaliculus was found to be replaced by a firm mass. The patient made an uneventful recovery.
The specimen consisted of a firm mass of 1. X 8. cm. which, on cutting was pinkish white [Figure - 2]. Attached to this was another fibrous shunken mass (sac) which was 7 x 3 mm. in dimensions. Microscopic examination with haematoxylin and eosin stain revealed that the lumen of the canaliculus was filled with a granulation mass consisting of round cells, plasma cells and histiocytes [Figure - 3]. At places there was organisation. The wall of the canaliculus was also infiltrated by similar cells and occasional giant cells [Figure - 4]. The sac wall was thickened fibrosed and had no lumen. Its anatomical diagnosis was intra-canalicular granuloma.
| Discussion|| |
The reports of non-specific granulomatous tumours are getting scantier in literature, the last being the report of Redi (1947). Six more references of this condition could be found earlier and no report of this condition has appeared subsequently. This, thus, appears to be the second commonest cause of a solid swelling of the lacrimal canaliculus, the commonest being a papilloma or a polypous, of which about a dozen reports are available.
| Summary|| |
A case of non-specific intra-canalicular granuloma is reported after a gap of sixteen years.
| References|| |
Baquis, M. (1931), Lettura Oft., 8, 434.
Duke-Elder, S. (1952), Text-book of Ophthalmology, Kimpton. London, p. 5295-96 & 5343-45.
Fazakas, A. (1937), Klin. M. Augenheilk.. 99, 372.
Nicholls. J. V. V. (1938), Canad. Med. A. S. J., 39, 569.
Redi, (1947), Rass. Ltd. d'ott., 16, 441.
Scheerer. R. (1931). Klin. M. Auger.. 86, 445.
Serra, H. (1926), Boll. d'Oc., 5, 331.
Wegner, W. (1926). Zeits. f. Augen, 57. 123.
[Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4]