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Repeated Lacrimal Gland Biopsies
Megha Kaushik1, Kaveh Vahdani, Inga Neumann
1Adnexal Service, Moorfields Eye Hospital, London, United Kingdom.
Ophthalmic Plastic and Reconstructive Surgery
|February 8, 2024
Summary
Repeated lacrimal gland biopsies can reveal new diagnoses, including malignancy and specific inflammatory conditions, especially when initial results are inconclusive or disease persists. This aids in accurate diagnosis and treatment planning for lacrimal gland disorders.
Area of Science:
- Ophthalmology
- Pathology
- Oncology
Background:
- Lacrimal gland biopsies are crucial for diagnosing various orbital pathologies.
- Nonspecific dacryoadenitis is a common initial diagnosis, but further investigation may be required.
Purpose of the Study:
- To evaluate the indications for performing repeat lacrimal gland biopsies.
- To determine the diagnostic yield of repeat biopsies in identifying new conditions.
Main Methods:
- Retrospective review of patients undergoing more than one lacrimal gland biopsy (2000-2022).
- Analysis of indications for repeat biopsy and changes in histopathological diagnosis.
Main Results:
- Of 123 patients, repeat biopsies were performed for diagnostic uncertainty, treatment resistance, or new/worsening contralateral disease.
- 33% of repeat biopsies yielded a different diagnosis, including 8% initially diagnosed with nonspecific dacryoadenitis (NSD) reclassified as lymphoma.
- 14% of NSD cases were reclassified as specific inflammatory conditions.
Conclusions:
- Repeat lacrimal gland biopsy is valuable for diagnosing malignancy (20%) and specific inflammatory diseases (14% progression from NSD).
- It is particularly useful in cases of diagnostic uncertainty or treatment failure.
