Pyogenic granulomas of the lacrimal sac

Eight cases of pyogenic granulomas of the lacrimal sac are reported. The clinical symptoms were consistent with chronic dacryocystitis which was unresponsive to previous probing and antibiotics. Extirpation of the sacs was done because of dacryocystocoele, pyocoele, or fistula formation through the skin. Trauma and inflammation were thought to have contributed to the growth of the pyogenic granulomas. The histopathological examination revealed nonspecific granulomas consisting of well vascularised, friable tissue of a myxomatous nature containing an infiltration of lymphocytes, plasma cells, and a few eosinophils. Over the granulomas an epithelial layer of cells is stretched showing no signs of dysplasia or neoplastic growth. The term 'lobular capillary hemangioma' has been suggested to describe lesions morphologically similar to those observed in the study. These masses made up 53.3% of a total of 15 lacrimal sac tumour biopsy specimens examined over a period of 10 years (1979-1989). The few reported cases of primary lacrimal sac tumour of non-epithelial origin suggest that they make up a large minority of the lacrimal sac tumours. A review shows that relatively few of these lesions have been described in recent English literature but these growths are probably not being as consistently reported as primary epithelial tumours.