lacrimal sarcoidosis
Introduction
Introduction to lacrimal glandular tumor Lacrimal glandular sarcoidosis is a disease caused by sarcoidosis. It is a granulomatous inflammation that affects multiple organs throughout the body. About 6% of those who invade the lacrimal gland are manifested as an unknown cause. The eyelids are not caseous necrotizing granuloma. The disease usually occurs in both eyes, no pain, easy to cause optic disc disease. basic knowledge The proportion of illness: 0.001% Susceptible people: no special people Mode of infection: non-infectious Complications: eye movement disorders
Cause
The cause of lacrimal gland tumor
(1) Causes of the disease
The cause is unknown and may be related to a variety of infections and immune dysfunction.
(two) pathogenesis
Its pathogenesis is not yet clear.
Prevention
Lacrimal glandular tumor prevention
1, early detection, early diagnosis, early treatment is the key to prevention of this disease.
2, local hot treatment, conjunctival drip with antibiotic eye water. If an abscess is formed, the drainage should be cut open. The lacrimal gland of the ankle is incision from the lateral skin of the upper eyelid, and the ankle is incision from the lateral conjunctiva.
3, to prevent some distant suppurative lesions, such as tonsillitis, otitis media, dental caries, pyelonephritis, etc., in order to avoid aggravating symptoms.
Complication
Lacrimal glandular tumor disease complications Complications, eye movement disorders
Dry keratoconjunctivitis, eye movement disorders, etc.
Symptom
Lacrimal glandular tumor disease symptoms Common symptoms Nodular lacrimal gland enlargement ptosis eye muscle paralysis
Often bilateral bilateral lacrimal gland enlargement, can occur sequentially, can also be unilateral, nodular, hard, painless, gradually increased, and associated with the iliac tissue, the tumor can be under the eyelid and under the eyelid Movement, lacrimal gland damage can cause dry keratoconjunctivitis, extraocular muscle involvement can cause restricted eye muscle paralysis, lifting the diaphragm and superior rectus muscle can cause ptosis, other eye manifestations can have conjunctival knot Section, discoid or banded corneal degeneration, scleral nodules and optic disc lesions.
Examine
Examination of lacrimal gland tumor
1. Angiotensin-transferase (ACE) is elevated in 1.50% to 80% of patients with sarcoidosis.
2. Pathological examination: Biopsy of orbital conjunctiva or orbital lesions can be found in the eye and lacrimal gland tissue is non-caseous necrotizing granulomatous inflammation, epithelial cells with lymphocytes, multinucleated giant cells and other nodule-like granulation swollen.
3. X-ray and CT scan: can show bilateral hilar nodular mass shadow.
4. Gallium scan: It can show abnormal glandular gland and hilar uptake, characteristic gallium uptake abnormality, combined with ACE elevation to diagnose the specificity of sarcoidosis more than 90%.
Diagnosis
Diagnosis and differentiation of lacrimal gland tumor
diagnosis
Bilateral lacrimal gland enlargement or orbital and conjunctival nodules, accompanied by lung, skin, lymph nodes and hepatosplenic lesions should be highly noticed. Plasma ACE elevation has special diagnostic value for this disease, orbital conjunctiva or eyelid Pathological histological examination of the diseased tissue biopsy can confirm the diagnosis.
Differential diagnosis
1. Wegner granuloma: one of the most common vasculitis with orbital manifestations, is an unexplained necrotizing granulomatous vasculitis, more common in 40 to 50 years old, male to female ratio is 2:1, often Involved in the eyes, joints, skin, heart and peripheral nerves, 50% of the eye manifestations have eyelid involvement, often bilateral eyelids are involved at the same time, orbital sarcoma, lacrimal gland inflammation and nasal lacrimal duct can occur simultaneously, more than 90% have sinus lesions, 60 Serum neutrophil cytoplasmic antibodies (ANCA) are elevated in % to 90% of patients. If the patient has ocular protrusion, inflammatory infiltration of the limbus, and respiratory, lung and kidney lesions, the diagnosis can be basically established.
2. Idiopathic inflammatory pseudotumor lacrimal gland type: acute manifestations of supraorbital orbital pain, edema on the lateral epicondyle, edema and hyperemia, upper sputum appeared in the "S" shape with ptosis, the conjunctiva of the supracondylar iliac crest Part of the lacrimal gland is red and swollen, with conjunctival edema and congestion, adjacent to the external rectus muscle can cause pain, eye movement restricted and diplopia, without systemic performance, chronic can be secondary to the acute type or chronic, performance For the painless lacrimal gland mass, CT showed that the lacrimal gland increased, the density increased evenly, the surrounding tissue was partially infiltrated, and there was no bone destruction. After treatment with corticosteroids, the symptoms were alleviated and the lesions were reduced.
