Two unusual cases of lacrimal sac inflammatory polyps with allergic mucin sine fungi

ABSTRACT

This case report deals with two patients with lacrimal sac swellings. Case 1 presented with bilateral sac swelling and Case 2 with a unilateral presentation. Dacrocystorhinostomy (DCR) followed by biopsies of both sacs in Case 1 revealed inflammatory polyps of the sac mucosa, identical in appearance to typical nasal allergic inflammatory polyps. The biopsies were accompanied by typical allergic mucin, featuring tiered mucin layers between which were numerous eosinophils, accompanied by Charcot–Leyden crystals. The histology of the dacryocystectomy specimen for Case 2 showed identical histopathological changes with the additional feature of prominent numbers of Immunoglobulin G (IgG)4-positive plasma cells in the stroma of the lacrimal sac inflammatory polyps. These features extend the sites affected by allergic inflammatory polyps and allergic mucin and possible pathogenesis is discussed.

KEYWORDS:

• Allergic mucin
• IgG4
• inflammatory polyp
• lacrimal sac

Author Contributions

Dr Imran Haq collated the clinical data and co-wrote the manuscript.

Dr Mudhar conceived the novelty of the histological observations and co-wrote the manuscript.

Dr Currie collated clinical and radiological data and edited the manuscript.

Dr Salvi and Dr Mirza collated clinical and radiological data, wrote parts of the manuscript and edited the manuscript.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.