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Keratinizing cyst of the lacrimal punctum
Yoshihiro Yonekawa1, Frederick A Jakobiec, Fouad R Zakka
1David G. Cogan Laboratory of Ophthalmic Pathology, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston, MA 02114, USA.
Purpose:
To describe the clinical and histopathologic features of the first reported punctal keratinizing cyst.
Methods:
Observational case report with clinical findings and paraffin-embedded tissue stained with hematoxylin and eosin.
Results:
A 54-year-old man presented with an outpouching in the region of the left upper lacrimal punctum. Microscopic examination revealed a cyst filled with needle-like keratin located in the proximal subpunctal canaliculus, with a small, mostly effaced punctal orifice with focal extrusion of keratin. The epithelial wall was composed of a crenellated, multilaminar, keratinizing squamous epithelium. There was no associated inflammation or foreign bodies.
Conclusions:
To the best of our knowledge, a punctal canalicular cyst, or any ectasia of the canaliculus or the lacrimal sac, has never before been reported primarily to contain keratin. As a new entity, this report broadens the differential diagnosis for lesions of the lacrimal drainage system.
