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The role of entrapped cilia on the formation of lacrimal ductular cysts

  • Clinical Investigation
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Abstract

Purpose

We sought to describe the histopathologic features of lacrimal ductular cysts with or without inflammation and speculate on the role of cilia in their pathogenesis.

Materials and methods

A retrospective study of 15 patients referred for lateral canthal subconjunctival cysts from 2001 to 2012 was conducted. All patients underwent cyst removal and a total histopathological examination was done. Patients were classified into 2 groups and analyzed according to their clinical and histopathologic characteristics.

Results

Fourteen showed unilateral disease and one had bilateral disease, with a mean age of 42.8 years. Six patients had mild discomfort or no symptoms, and the remaining 9 of 15 patients presented with a symptomatic mass with conjunctival discharge and injection. Two layers of ductal epithelium constituted the whole wall of the cyst in the seven non-inflammatory cysts, three of which showed cilia in the lumen. The presence of stratified columnar epithelium with goblet cells was a peculiar feature in the lining of the nine inflammatory cases, seven of which showed cilia shafts with inflammatory cells and concrete material in the lumen. Pilosebaceous units were not evident in any of the specimens on pathologic examination.

Conclusion

Cilia entrapped in the lacrimal ductule may play a role in the formation of lacrimal ductular cysts with or without inflammation. Cilia falling from the eyelid may be caught in the conjunctival fornix then shift toward the horizontal lacrimal ductule in the lateral canthus. It may then serve as a nidus to provoke lacrimal ductular inflammation or cyst formation.

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References

  1. Smith S, Rootman J. Lacrimal ductal cysts. Presentation and management. Surv Ophthalmol. 1986;30:245–50.

    Article  CAS  PubMed  Google Scholar 

  2. Salam A, Barrett AW, Malhotra R, Olver J. Marsupialization for lacrimal ductular cysts (dacryops): a case series. Ophthalmic Plast Reconstr Surg. 2012;28:57–62.

    Article  Google Scholar 

  3. Yanoff M, Fine BS. Ocular pathology. 5th ed. Philadelphia: Mosby; 2002. p. 545–6.

    Google Scholar 

  4. Tsiouris AJ, Deshmukh M, Sanelli PC, Brazzo BG. Bilateral dacryops: correlation of clinical, radiologic, and histopathologic features. AJR Am J Roentgenol. 2005;184:321–3.

    Article  PubMed  Google Scholar 

  5. Baker RH, Bartley GB. Lacrimal gland ductule stones. Ophthalmology. 1990;97:531–4.

    Article  CAS  PubMed  Google Scholar 

  6. Zafar A, Jordan DR, Brownstein S, Faraji H. Asymptomatic lacrimal ductule dacryolithiasis with embedded cilia. Ophthalmic Plast Reconstr Surg. 2004;20:83–5.

    Article  Google Scholar 

  7. Hay-Smith G, Rose GE. Lacrimal gland ductulitis caused by probable Actinomyces infection. Ophthalmology. 2012;119:193–6.

    Article  PubMed  Google Scholar 

  8. Brownstein S, Belin MW, Krohel GB, Smith RS, Condon G, Codere F. Orbital dacryops. Ophthalmology. 1984;91:1424–8.

    Article  CAS  PubMed  Google Scholar 

  9. Betharia SM, Pushker N, Sharma V, Sen S. Simple dacryops: a case series and review of the literature. Ophthalmologica. 2002;216:372–6.

    Article  CAS  PubMed  Google Scholar 

  10. Mawn LA, Sanon A, Conlon MR, Nerad JA. Pseudomonas dacryoadenitis secondary to a lacrimal gland ductule stone. Ophthalmic Plast Reconstr Surg. 1997;13:135–8.

    Article  CAS  Google Scholar 

  11. Hunts JH, Patrinely JR, Matoba AY, Font RL. Conjunctival cilia entrapment: an unrecognized cause of ocular irritation. Ophthalmic Plast Reconstr Surg. 1997;13:289–92.

    Article  CAS  Google Scholar 

  12. Baratz KH, Bartley GB, Campbell RJ, Garrity JA. An eyelash nidus for dacryoliths of the lacrimal excretory and secretory systems. Am J Ophthalmol. 1991;111:624–7.

    Article  CAS  PubMed  Google Scholar 

  13. da Silva JH. Pilonidal cyst: cause and treatment. Dis Colon Rectum. 2000;43:1146–56.

    Article  PubMed  Google Scholar 

  14. Hull TL, Wu J. Pilonidal disease. Surg Clin North Am. 2002;82:1169–85.

    Article  PubMed  Google Scholar 

  15. Wang Y, Su F, Li Y, Xiao L. Orbital dermoid cyst with sinus tract mimicking ectopic cilia. J AAPOS. 2010;14:532–3.

    Article  PubMed  Google Scholar 

  16. Bron AJ. Lacrimal sterams: the demonstration of human lacrimal fluid secretion and the lacrimal ductules. Br J Ophthalmol. 1986;70:241–5.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  17. Duke-Elder S, Wybar KC. Anatomy of the visual system. In: Duke-Elder S, editor. System of ophthalmology. Vol 2. St. Louis: CV Mosby; 1961.

  18. Dong N, Li W, Lin H, Wu H, Li C, Chen W, et al. Abnormal epithelial differentiation and tear film alteration in pinguecula. Invest Ophthalmol Vis Sci. 2009;50:2710–5.

    Article  PubMed  Google Scholar 

  19. Yu XM, Li CW, Li YY, Liu J, Lin ZB, Li TY, et al. Down-regulation of EMP1 is associated with epithelial hyperplasia and metaplasia in nasal polyps. Histopathology. 2013;63:686–95.

    PubMed  Google Scholar 

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Conflicts of interest

J. Y. Lee, None; K. I. Woo, None; Y.-L. Suh, None; Y.-D. Kim, None.

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Authors and Affiliations

  1. Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Korea

    Ju Yeon Lee, Kyung In Woo & Yoon-Duck Kim

  2. Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

    Yeon-Lim Suh

Authors
  1. Ju Yeon Lee
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  2. Kyung In Woo
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  3. Yeon-Lim Suh
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  4. Yoon-Duck Kim
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Correspondence to Kyung In Woo.

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Lee, J.Y., Woo, K.I., Suh, YL. et al. The role of entrapped cilia on the formation of lacrimal ductular cysts. Jpn J Ophthalmol 59, 81–85 (2015). https://doi.org/10.1007/s10384-014-0360-2

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  • DOI: https://doi.org/10.1007/s10384-014-0360-2

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