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The radiological spectrum of orbital pathologies that involve the lacrimal gland and the lacrimal fossa.

Jung WS, Ahn KJ, Park MR, Kim JY, Choi JJ, Kim BS, Hahn ST - Korean J Radiol (2007 Jul-Aug)

Bottom Line: The developmental cystic lesions found in the lacrimal fossa such as dermoid and epidermoid cysts can be diagnosed when the cyst involves the superior temporal quadrant of the orbit and manifests as a non-enhancing cystic mass and, in case of a lipoma, it is diagnosed as a total fatty mass.A careful clinical evaluation and moreover, a pathologic verification, are needed.In this pictorial review, the various imaging spectrums of pathologic masses involving the lacrimal gland and fossa are presented, along with appropriate anatomy and pathology reviews.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, St Mary's Hospital, Catholic University College of Medicine, 62 Youido-dong, Youngdeungpo-gu, Seoul 150-713, Korea.

ABSTRACT
CT and MRI are utilized to differentiate between different types of masses and to determine the extent of lesions involving the lacrimal gland and the fossa. Although many diseases that affect the lacrimal gland and fossa are specifically diagnosed by imaging, it is frequently very difficult to differentiate each specific disease on the basis of image characteristics alone due to intrinsic similarities. In lacrimal gland epithelial tumors, benign pleomorphic adenomas are seen most commonly with a well defined benign appearance, and a malignant adenoid cystic carcinoma is seen with a typical invasive malignant appearance. However, a malignant myoepithelial carcinoma is seen with a benign looking appearance. Lymphomatous lesions of the lacrimal gland include a broad spectrum ranging from reactive hyperplasia to malignant lymphoma. These lesions can be very difficult to differentiate both radiologically and pathologically. Generally, lymphomas tend to occur in older patients. The developmental cystic lesions found in the lacrimal fossa such as dermoid and epidermoid cysts can be diagnosed when the cyst involves the superior temporal quadrant of the orbit and manifests as a non-enhancing cystic mass and, in case of a lipoma, it is diagnosed as a total fatty mass. However, masses of granulocytic sarcoma and xanthogranuloma, as well as vascular masses, such as a hemangiopericytoma, are difficult to diagnose correctly on the basis of preoperative imaging findings alone. A careful clinical evaluation and moreover, a pathologic verification, are needed. In this pictorial review, the various imaging spectrums of pathologic masses involving the lacrimal gland and fossa are presented, along with appropriate anatomy and pathology reviews.

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A dermoid cyst in a 49-year-old woman.A coronal CT scan shows a fat-containing mass with nodular calcification in the superior lateral aspect of right orbit (arrow).
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Figure 10: A dermoid cyst in a 49-year-old woman.A coronal CT scan shows a fat-containing mass with nodular calcification in the superior lateral aspect of right orbit (arrow).

Mentions: Most of these lesions are slow-growing, but some may show rapid growth in adults. Dermoid and epidermoid cysts are seen as non-enhancing low-density masses on CT images. Dermoid cysts may show fat densities and calcification (Fig. 10). On MRI, they are seen as low signal intensities on T1-weighted images and high signal intensities on T2-weighted images, and they can exhibit characteristic fat signal intensity (4).


The radiological spectrum of orbital pathologies that involve the lacrimal gland and the lacrimal fossa.

Jung WS, Ahn KJ, Park MR, Kim JY, Choi JJ, Kim BS, Hahn ST - Korean J Radiol (2007 Jul-Aug)

A dermoid cyst in a 49-year-old woman.A coronal CT scan shows a fat-containing mass with nodular calcification in the superior lateral aspect of right orbit (arrow).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2627159&req=5

Figure 10: A dermoid cyst in a 49-year-old woman.A coronal CT scan shows a fat-containing mass with nodular calcification in the superior lateral aspect of right orbit (arrow).
Mentions: Most of these lesions are slow-growing, but some may show rapid growth in adults. Dermoid and epidermoid cysts are seen as non-enhancing low-density masses on CT images. Dermoid cysts may show fat densities and calcification (Fig. 10). On MRI, they are seen as low signal intensities on T1-weighted images and high signal intensities on T2-weighted images, and they can exhibit characteristic fat signal intensity (4).

Bottom Line: The developmental cystic lesions found in the lacrimal fossa such as dermoid and epidermoid cysts can be diagnosed when the cyst involves the superior temporal quadrant of the orbit and manifests as a non-enhancing cystic mass and, in case of a lipoma, it is diagnosed as a total fatty mass.A careful clinical evaluation and moreover, a pathologic verification, are needed.In this pictorial review, the various imaging spectrums of pathologic masses involving the lacrimal gland and fossa are presented, along with appropriate anatomy and pathology reviews.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, St Mary's Hospital, Catholic University College of Medicine, 62 Youido-dong, Youngdeungpo-gu, Seoul 150-713, Korea.

ABSTRACT
CT and MRI are utilized to differentiate between different types of masses and to determine the extent of lesions involving the lacrimal gland and the fossa. Although many diseases that affect the lacrimal gland and fossa are specifically diagnosed by imaging, it is frequently very difficult to differentiate each specific disease on the basis of image characteristics alone due to intrinsic similarities. In lacrimal gland epithelial tumors, benign pleomorphic adenomas are seen most commonly with a well defined benign appearance, and a malignant adenoid cystic carcinoma is seen with a typical invasive malignant appearance. However, a malignant myoepithelial carcinoma is seen with a benign looking appearance. Lymphomatous lesions of the lacrimal gland include a broad spectrum ranging from reactive hyperplasia to malignant lymphoma. These lesions can be very difficult to differentiate both radiologically and pathologically. Generally, lymphomas tend to occur in older patients. The developmental cystic lesions found in the lacrimal fossa such as dermoid and epidermoid cysts can be diagnosed when the cyst involves the superior temporal quadrant of the orbit and manifests as a non-enhancing cystic mass and, in case of a lipoma, it is diagnosed as a total fatty mass. However, masses of granulocytic sarcoma and xanthogranuloma, as well as vascular masses, such as a hemangiopericytoma, are difficult to diagnose correctly on the basis of preoperative imaging findings alone. A careful clinical evaluation and moreover, a pathologic verification, are needed. In this pictorial review, the various imaging spectrums of pathologic masses involving the lacrimal gland and fossa are presented, along with appropriate anatomy and pathology reviews.

Show MeSH
Related in: MedlinePlus