|
|
CASE REPORT |
|
Year : 1983 | Volume
: 31
| Issue : 2 | Page : 87-88 |
|
Fibrous histiocytoma of the lacrimal sac (A case report)
Arup Das, S Chowdhury, JN Mitra, P Sengupta, IS Roy
Regional Institute of Ophthalmology, Medical College, Calcutta, India
Correspondence Address: I S Roy Director, Regional Institute of Ophthalmology, Medical College, Calcutta-700073 India
Source of Support: None, Conflict of Interest: None | Check |
PMID: 6319277
How to cite this article: Das A, Chowdhury S, Mitra J N, Sengupta P, Roy I S. Fibrous histiocytoma of the lacrimal sac (A case report). Indian J Ophthalmol 1983;31:87-8 |
Fibrous histiocytoma is a rare tumour either with a benign or malignant course. It is more commonly found in the Orbit[1],[2],[3], and the other less frequent sites are conjunctiva[4], tarsus[5] and ciliary body[6]. So far three cases of histiocytoma of the lacrimal sac have been reported in the literature[7],[8]. Here one more similar case is reported.
Case report | | |
A 38 year-old male. S.B.. complained of watering in the right eye for one year and a half, and also of a slowly progressing swelling in the region of the right lacrimal sac for the last six months.
On examination of his right eye, there was no conjunctiva) congestion. The eyeball was normal and the visual acuity was 6/6. A swelling of 10 mm x 15 mm was found in the region of the right lacrimal sac. It was nontender and firm in consistency. On pressure over the swelling there was slight mucous regurgitation from the lower punctum. The syringing done on several occasions showed that the right naso-lacrimal passage was partially patent. The patient was treated with topical sodium sulfa-acetamide and chloramphenicol drops but with no effect.
The patient was admitted as a case of right-sided mucocele for dacryocystorhinostomy (DCR) operation, if possible. After the skin incision, a tense, brown firm swelling tinder the expanded medial palpebral ligament was found. It was well encapsulated and the whole mass was separated easily from the surrounding tissues. The thickwalled capsulated mass was sent for histopathological examination. The mass was 8 mm X 12 mm x 10 mm. in size.
Pathological examination
The excised mass was fixed, processed, sectioned and stained with hematoxylin and eosin. Bands of spindle cells often arranged in a storiform pattern were the presenting feature. There were also scattered histiocytes with abundant cytoplasm and foam cells. No mitoses were found in the cells. The histological diagnosis was benign fibrous histiocytoma of the lacrimal sac [Figure - 1][Figure 2].
Discussion | | |
The studies of Kauffman and Stout[9] have shown that fibrohistiocytoma originates from the histiocyte cell. They suggested that the pluripotency of the histiocyte might be responsible for the variation of the cellular type and fibrous tissue in such tumours. So, they designated tumours with predominantly cellular components as histiocytomas and those with predominantly fibrous components as fibroxanthomas. Recently Fu et al[10] considered the primitive mesenchyme cell to be the cell of origin of fibrohistiocytorna.
Rarely, fibrohistiocytomas may take a malignant course. In a series of 1516 patients with fibrohistiocytoma, O' Brien and Stout[11] found only 1 % cases to be malignant.
Fibrohistiocytoma commonly involves the orb it[1],[2],[3], sub Cases of involvement of conjunctiva and ciliary body[4], tarsus[5], corneoscleral limbus[12] and conjunctiva[6], although rare, have been reported. The incidence of fibrohistiocytoma of the lacrimal sac is extremely rare, first reported by Cole and Ferry[7] in 1978. Recently two additional cases have been described by Marback et al[8]. No case of histiocytoma of the lacrimal sac has been previously reported from India.
Before operation, it was never thought to be a case of lacrimal sac tumour and so a DCR aperation was planned. But it was only after exposure it was decided a dacryocvstectomy to be performed, and to the surprise, the histopathological examination of the mass revealed a fibrous histiocytoma of the lacrimal sac.
Summary | | |
A rare case of fibrous histiocytoma of the lacrimal sac has been reported.
References | | |
1. | Jakobiec, F.A., Howard, G.M.. Jones, I.S. and Taunebaum. M., 1974, Amer. J. Ophthalmol. 77:333 |
2. | Rodrignes, M.M., Furginelie. F.P. and weinreb, S., 1977, Arch. Ophthalmol. 95: 2025 |
3. | Biedner, B. and Rothhoff, L. 1978, Amer. J. Ophthalmol 80: 548 |
4. | Alber, D.M. and Smith. R.S. 1968, Arch. Ophthalmol, 80:474 |
5. | Jakobiec. F.A., Devoe A.G. and Boyd, J., 1977, Amer J. Ophthalmol. 84 : 794. |
6. | Delgrado-partida, P.& Rodrignez-Trujillo, F., 1912, Amer. J. Ophthalmol. 74: 479. |
7. | Cole. S.H. and Ferry, A.P., 1978, Arch. Ophthalmol,. 96 : 1647. |
8. | Marback. R.L., Kincaid. M.C., Green, W.R. and Miff, W.J., 1982. Amer. J. Ophthalmol. 93 511 |
9. | Kauffmam, S. L. and Stout, A.P. 1961. Cancer, 14:49 |
10. | Fu, Y.S., Gabbiani, G.. Kaye, G.I. and Lattes, R.. 1975, Cancer. 35 : 176. |
11. | O'Brien, J.E. and Stout, A.P., 1964, Cancer, 17 : 1445. |
12. | Faludi. J.E.. Ken yen. 80 K. and Green. W.R.. 1975, Amer. J. Ophthalmol. 80 : 619. |
[Figure - 1]
|