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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 granulocytic sarcoma from chronic myeloid leukemia in a 40-year-old man. A gadolinium-enhanced T1-weighted axial image shows bilaterally-enlongated masses with strong enhancement in the superior lateral aspect of both orbits. Soft tissue infiltrations are noted around the right orbit mass.
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Figure 14: A granulocytic sarcoma from chronic myeloid leukemia in a 40-year-old man. A gadolinium-enhanced T1-weighted axial image shows bilaterally-enlongated masses with strong enhancement in the superior lateral aspect of both orbits. Soft tissue infiltrations are noted around the right orbit mass.

Mentions: The uvea, choroids, retina and optic nerve may first be involved, and this involvement appears as a diffuse or localized thickening on the images. In a case where orbital soft tissue is involved, this tumor primarily involves the orbital fat and it can extend to the lacrimal gland. On MRI imaging, it shows almost the same intensity as muscle on a T1-weighted image, while it is observed with greater intensity on a T2-weighted image. For our case, the granulocytic sarcoma involved the lacrimal gland and adjacent fat (Fig. 14).


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 granulocytic sarcoma from chronic myeloid leukemia in a 40-year-old man. A gadolinium-enhanced T1-weighted axial image shows bilaterally-enlongated masses with strong enhancement in the superior lateral aspect of both orbits. Soft tissue infiltrations are noted around the right orbit mass.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 14: A granulocytic sarcoma from chronic myeloid leukemia in a 40-year-old man. A gadolinium-enhanced T1-weighted axial image shows bilaterally-enlongated masses with strong enhancement in the superior lateral aspect of both orbits. Soft tissue infiltrations are noted around the right orbit mass.
Mentions: The uvea, choroids, retina and optic nerve may first be involved, and this involvement appears as a diffuse or localized thickening on the images. In a case where orbital soft tissue is involved, this tumor primarily involves the orbital fat and it can extend to the lacrimal gland. On MRI imaging, it shows almost the same intensity as muscle on a T1-weighted image, while it is observed with greater intensity on a T2-weighted image. For our case, the granulocytic sarcoma involved the lacrimal gland and adjacent fat (Fig. 14).

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