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Nasolacrimal Lavage as a Treatment for Ocular Surface Toxic Soup Syndrome
Published on: April 25, 2025
Reactive lymphoid hyperplasia of the nasolacrimal duct presenting as bloody epiphora
Eric J Wolf1, Matthew M Wessel, Marc D Hirsch
1The Edward S. Harkness Eye Institute, Columbia University College of Physicians and Surgeons, New York, New York, USA.
Abstract:
A 90-year-old man reported a 1-year history of tearing and irritation in the left eye. Ophthalmic examination was significant for bloody mucopurulent material expressed from the left nasolacrimal duct. The patient underwent external dacryocystorhinostomy with excision of a soft-tissue mass. Initial histopathologic examination of the specimen revealed an atypical lymphoid infiltrate. Subsequent immunohistochemistry suggested that the mass was reactive lymphoid hyperplasia. Lymphoid hyperplasia should be considered in the differential diagnosis of bloody epiphora, in addition to primary malignancy of the nasolacrimal duct, hematologic abnormalities, coagulopathies, vascular tumors, and giant papillary conjunctivitis.
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