Histopathological features of asymmetric lacrimal gland enlargement in patients with thyroid eye disease.

IF 1.9 Q3 ENDOCRINOLOGY & METABOLISM Thyroid Research Pub Date : 2023-08-14 DOI:10.1186/s13044-023-00174-4
Pav Gounder, Huw Oliphant, Valerie Juniat, Michael Koenig, Dinesh Selva, Saul N Rajak
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Abstract

Purpose: Lacrimal gland enlargement can be a feature of thyroid eye disease (TED). Unilateral or asymmetric lacrimal gland enlargement is poorly described and may impede diagnosis. We present the histological and clinical findings of four patients with asymmetric lacrimal gland enlargement.

Methods: A retrospective case note review was performed for patients over two tertiary orbital clinics (Royal Adelaide Hospital, South Australia and the Sussex Eye Hospital, Brighton, United Kingdom) presenting with an asymmetrical lacrimal gland enlargement with a background of TED that underwent biopsy to exclude alternate diagnoses. Baseline data was collected for each patient and histopathological images and reports were reviewed.

Results: All four patients were hyperthyroid at time of lacrimal gland biopsy. Biopsy demonstrated nonspecific, lymphoid aggregates, typically of B cell type, with no diagnostic findings to support lymphocyte clonality or IgG4-related disease. One biopsy specimen demonstrated evidence of some fibrosis.

Conclusion: Asymmetrical lacrimal gland enlargement can occur as part of the TED spectrum but may require biopsy to exclude alternate pathology. Histology demonstrates a non-specific lymphocytic infiltrate.

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甲状腺眼病患者不对称泪腺肿大的组织病理学特征。
目的:泪腺肿大可能是甲状腺眼病(TED)的一个特征。单侧或不对称的泪腺肿大描述不佳,可能妨碍诊断。我们报告了4例不对称泪腺肿大患者的组织学和临床表现。方法:对两家三级眼眶诊所(南澳大利亚皇家阿德莱德医院和英国布莱顿苏塞克斯眼科医院)的患者进行回顾性病例回顾,这些患者表现为不对称泪腺肿大,伴有TED背景,并进行活检以排除其他诊断。收集每位患者的基线数据,并回顾组织病理学图像和报告。结果:4例患者泪腺活检时均为甲状腺功能亢进。活检显示非特异性淋巴样聚集体,典型的B细胞型,没有诊断结果支持淋巴细胞克隆或igg4相关疾病。一个活检标本显示有一些纤维化的证据。结论:不对称的泪腺肿大可以作为TED频谱的一部分发生,但可能需要活检来排除其他病理。组织学显示非特异性淋巴细胞浸润。
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来源期刊
Thyroid Research
Thyroid Research Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
3.10
自引率
4.50%
发文量
21
审稿时长
8 weeks
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