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Selektive Tränensackbiopsie bei externer Dakryozystorhinostomie

Eine klinisch-pathologische Studie

Selective lacrimal sac biopsy for external dacryocystorhinostomy

A clinical pathological study

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Zusammenfassung

Hintergrund

Tränenwegstumoren sind selten, aber potenziell lebensbedrohlich. Ziel war es, die Anwendbarkeit der selektiven Tränensackbiopsie bei 500 externen Dakryozystorhinostomien von Patienten mit erworbener Tränenwegsstenose zu untersuchen.

Patienten und Methoden

Eine Biopsie wurde selektiv bei klinisch und/oder intraoperativ atypischen Befunden gewonnen. Häufigkeit und Spektrum der Biopsate wurden erfasst, und mit den Follow-up-Ergebnissen korreliert.

Ergebnisse

Eine Tränensackbiopsie erfolgte bei 19 externen Dakryozystorhinostomien (3,8%): Non-Hodgkin-B-Zell-Lymphom (3), Plattenepithelkarzinom (2), Mukoepidermoidkarzinom (1), malignes Melanom (1), Onkozytom (1), pyogenes Granulom (4), Wegener-Granulomatose (4), Sarkoidose (3). Innerhalb von 5 Jahren entwickelte keiner der Patienten ohne Biopsie entzündliche Systemerkrankungen oder Tränenwegsneoplasien. Die Fünfjahresüberlebensrate betrug bei Patienten mit signifikanter Tränenwegspathologie 87%, bei Patienten ohne signifikante Pathologie 96%.

Schlussfolgerung

Die externe Dakryozystorhinostomie mit selektiver Biopsie klinisch und intraoperativ atypischer Befunde erlaubt eine zuverlässige Diagnose und Therapie potenziell lebensbedrohlicher Tränenwegsprozesse.

Abstract

Background

Tumors of the lacrimal drainage system are rare but potentially life-threatening. The purpose of this study was to investigate the applicability of selective lacrimal sac biopsy in 500 cases of external dacryocystorhinostomy for acquired dacryostenosis.

Patients and methods

Lacrimal sac biopsy was obtained selectively for atypical clinical and/or intraoperative findings. The frequency and spectrum of biopsies were recorded and correlated with the follow-up results.

Results

Lacrimal sac biopsy was performed in 19 external dacryocystorhinostomies (3.8%) including non-Hodgkin B-cell lymphoma (3), squamous carcinoma (2), mucoepidermoid carcinoma (1), malignant melanoma (1), oncocytoma (1), pyogenic granuloma (4), Wegener’s granulomatosis (4) and sarcoidosis (3). Within 5 years none of the patients without biopsy developed systemic inflammatory diseases or lacrimal neoplasms. The 5-year survival was 87% in patients with significant lacrimal sac pathology and 96% in patients without significant pathology.

Conclusion

External dacryocystorhinostomy with selective biopsy for atypical clinical and intraoperative findings allows safe diagnosis and management of potentially life-threatening lacrimal lesions.

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Authors and Affiliations

  1. Augenklinik mit Poliklinik, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schwabachanlage 6, 91054, Erlangen, Deutschland

    L.M. Heindl, E. Treutlein, A.G.M. Jünemann, F.E. Kruse & L.M. Holbach

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  1. L.M. Heindl
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  2. E. Treutlein
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  3. A.G.M. Jünemann
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  4. F.E. Kruse
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  5. L.M. Holbach
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Correspondence to L.M. Heindl.

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Heindl, L., Treutlein, E., Jünemann, A. et al. Selektive Tränensackbiopsie bei externer Dakryozystorhinostomie. Ophthalmologe 107, 1139–1144 (2010). https://doi.org/10.1007/s00347-010-2200-1

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  • DOI: https://doi.org/10.1007/s00347-010-2200-1

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