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Nasolacrimal Lymphangioma Presenting With Hemolacria
Emily Li1, Rebecca A Yoda2, C Dirk Keene2
1Department of Ophthalmology, University of Washington School of Medicine, Seattle, Washington.
Insights
A rare vascular malformation, nasolacrimal lymphangioma, caused bloody tearing (hemolacria) in a young man. Treatment with nasolacrimal stenting resolved the condition, highlighting this as a potential cause of bloody tearing.
Area of Science:
- Ophthalmology
- Vascular Malformations
- Head and Neck Surgery
Background:
- Unilateral hemolacria, or bloody tearing, can have various causes.
- Nasolacrimal duct obstruction often presents with epiphora and dacryocystitis.
- Vascular malformations are infrequently considered in the differential diagnosis of hemolacria.
Observation:
- A 22-year-old male presented with spontaneous unilateral hemolacria.
- Physical examination revealed complete opacification of the ipsilateral nasolacrimal sac and duct.
- Endoscopic biopsy was performed for definitive diagnosis.
Findings:
- Histopathologic analysis confirmed the diagnosis of nasolacrimal lymphangioma.
- This represents the first reported case of a lymphangioma involving the nasolacrimal system.
- The vascular malformation was identified as the cause of the bloody tearing.
Implications:
- Nasolacrimal lymphangioma should be considered in the differential diagnosis of hemolacria.
- Endoscopic biopsy is crucial for accurate diagnosis of nasolacrimal masses.
- Nasolacrimal stenting can be an effective treatment for resolving hemolacria caused by this condition.
Abstract:
A 22-year-old male presented with spontaneous unilateral hemolacria and was found to have complete opacification of the ipsilateral nasolacrimal sac and duct. Endoscopic biopsy with histopathologic analysis revealed the diagnosis of nasolacrimal lymphangioma. Additional management included nasolacrimal stenting, and there was no hemolacria recurrence or epiphora. This is the first report of a nasolacrimal lymphangioma and describes the vascular malformation as a potential cause of bloody tearing.
