Lacrimal Sac Lymphomas: Clinical Presentation, Diagnostic Challenges, and Management – A Focused Review with Institutional Experience
Dalal Fatani
ABSTRACT
Purpose: To provide an updated focused review of lacrimal sac lymphomas, highlighting epidemiology, clinical presentation, diagnostic workup, histopathological subtypes, management strategies, and outcomes, supplemented by institutional experience.
Methods: Narrative literature review of lacrimal sac lymphomas with contextual reference to cases identified at a tertiary eye hospital.
Results: Lacrimal sac lymphomas are rare lesions of the lacrimal drainage system, most commonly diffuse large B-cell lymphoma (DLBCL) and mucosa associated lymphoid tissue (MALT) lymphoma. Presentation frequently mimics primary acquired nasolacrimal duct obstruction, leading to diagnostic delay. Cross-sectional imaging may show a solid lacrimal sac mass with possible extension to adjacent structures. Radiotherapy is commonly used for localized disease, while systemic therapy is employed for high-grade histologies or disseminated involvement.
Conclusions: Lacrimal sac lymphomas require a high index of suspicion in atypical, recurrent, or unilateral lacrimal outflow obstruction. Timely biopsy with appropriate immunophenotyping and multidisciplinary care are essential for optimal outcomes
