Involvement of bilateral lacrimal gland in systemic Hodgkin disease

Öz

Five percent (5%) of lacrimal gland tumors are originated from lymphoid tissue. In one type of Hodgkin disease which is abounding in lymphocytes, involvement of lacri­mal gland is a rather rare entity. A 48 – year old woman who had swollen both eyelids, applied to department of oculoplasty in our clinic. At in­spection, when eyelids were rotated, a mass was seen at the region which fits to bilateral lacrimal gland area. Magnetic resonance imaging of the orbita showed a well-demarcated soft tissue mass without invade adjacent structure in the supero-lateral aspect of the bilateral orbit, occupying lacrimal gland. Lymphadenopathies in abdomi­nal, cervical, inguinal, axillary regions have been found in systemic scanning. Biopsy of lacrimal gland and axillary lymphadenopahty were performed and histopathological examination revealed the diagnosis as Hodgkin disease abounding in lymphocytes. The patient was underwent four cure chemotherapy. Clinical and tomographic find­ings were found to be regressed after treatment.

Anahtar Kelimeler

• Hodgkin disease, lacrimal gland, bilateral in­volvement, chemotherapy

Sistemik Hodgkin hastalığında iki taraflı lakrimal bez tutulumu

Öz

Lakrimal gland tümörlerinin %5\'i lenfoid dokudan köken alır. Hodgkin Hastalığının lenfositten zengin tipinde lakri­mal gland tutulumu ise oldukça nadir bir durumdur. Kliniğimiz okuloplasti birimine başvuran, 48 yaşındaki kadın hastanın şikayeti her iki göz kapağında şişlik idi. Muayenede kapaklar çevrildiğinde bilateral lakrimal glan­da uyan bölgede kitle görüldü. Orbita manyetik rezonans görüntülemesinde bilateral bulbus okuli süperolateralin­de, lakrimal bezi tutan, sınırları belirgin, komşu yapıla­ra invazyon göstermeyen, yumuşak doku kitlesi izlendi. Sistemik taramada abdominal, servikal, inguinal, aksiller bölgelerde lenfadenopatilere rastlandı. Lakrimal gland ve aksiller lenf nodu biyopsileri yapıldı. Histopatolojik tanı lenfositten zengin Hodgkin Hastalığı olarak rapor edildi. Hastaya dört kür kemoterapi verildi. Tedavi sonrasında klinik görünüm ve tomografik incelemede bulguların ge­rilediği saptandı.

Anahtar Kelimeler

• Hodgkin hastalığı, lakrimal gland, bi­lateral tutulum, kemoterapi

Kaynakça

1. Bairey O, Kremer I, Rakowsky E, Hadar H, Shaklai M.Orbital and adnexal involvement in systemic Non-Hodgkin’s lym- phoma. Cancer 1994;73:2395-2399.
2. Barışta İ, Güllü İ, Akpek B, Demirkazık F, Ayhan A, Baltalı E, Tekuzman G, Fırat D: Non-Hodgkin lenfomalarda oküler ve orbital tutulum. T Oft Gaz 1994;24:392-395.
3. Liang R, Loke SL, Chiu E.A clinico-pathological cases of Non-Hodgkin lymphoma involving in orbit. Acta Oncol 1991;30:335-338.
4. Jenkins C, Rose GE, Bunce C, Cree I, Norton A, Plowman PN, Moseley I, Wright JE. Clinical features associated with survival of patients with lymphoma of the ocular adnexa. Eye 2003;17:809-820.
5. Crawford JB. Conjunctival tumours. In: Tasman W, Jaeger EA, eds. Duane’s clinical ophthalmology, Vol. 4. Philadel- phia: JB Lippincott, 1994;10:2-10:6.
6. Klapper SR, Jordan DR, McLeish W, Pelletier C. Unilateral proptosis in an immunocompetant man as the initial clinical manifestation of systemic Hodgkin disease. Ophthalmol- ogy 1999;106:338-341.
7. Rosenburg PA, Kaplan HS. Evidence for an orderly pro- gression in the spread of Hodgkin’s disease. Cancer Res 1996;26:1225-31.
8. Fitzpatrick PJ, Macko S. Lymphoreticular tumours of the or- bit. Int J Radiation Oncol Biol Phys 1984;10:333-340.

9. Vaughan GJ, Dortzbach RK. Eyelid malignancies. In: Yanoff M, Duker JS. Ophthalmology. Mosby. 1999;7:12-16.
10. Tiwari RM. Lymphosarcoma of lacrimal gland. Laryngo- scope 1971;81:1519-1523.