Abstract
Objective To explore the clinical manifestations, imaging characteristics, and pathological characteristics of Castleman's disease of the lacrimal gland, enhance the knowledge of the disease, and improve the level of its diagnosis and treatment. Methods In the retrospective study, the data of 5 patients diagnosed with Castleman's disease of the lacrimal gland in Tianjin Medical University Eye Hospital from 2014 to 2018 were analyzed, and the relevant literature was reviewed. Results All the 5 patients were confirmed by pathological examination. Clinical manifestations were characterized by mass occupying lesions in the lacrimal gland area, without obvious pain, accompanied by eyelid swelling and ptosis, as well as space-occupying symptoms. Imaging examination showed that there was a soft tissue mass in the enlarged lacrimal gland area, and the mass was rich in blood flows while showing no obvious specificity, which could invade the surrounding muscles. All patients underwent surgical resection. Pathological results showed that 1 case was of the hyaline-vascular type, 3 cases were of the plasma cell type, and 1 case showed malignant transformation to plasma cell tumor. Conclusion Castleman's disease of the lacrimal gland is a rare orbital lymphoproliferative disease lacking specificity in clinical manifestations and imaging examination. As there are difficulties in differentiating the disease from orbital inflammatory pseudotumor and orbital lymphoma, its diagnosis still depends on pathological examination. The disease is mainly treated with surgical resection, and the pathological type is determined postoperatively.
Highlights
Castleman’s disease (CD) is a rare chronic lymphoproliferative disease in the clinic, usually involving the mediastinum, neck, retroperitoneum, axilla, groin, and other regions rich in lymph nodes [1]
CD mainly involves lymph nodes, and extranodal tissue involvement is noted occasionally. It includes the hyalinevascular type, plasma cell type, and mixed type. e lacrimal gland is an orbital autoimmune organ, which is a common site of orbital lymphoproliferative diseases. e author received and treated 5 cases of CD involving the lacrimal gland from 2014 to 2018 and analyzed their clinical manifestations, imaging characteristics, and pathological features in the combination of the relevant literature, aiming to enhance the knowledge of ophthalmologists on the disease and improve the diagnosis and treatment level
E lacrimal gland was involved in all cases, unilateral in 3 cases and bilateral in 2 cases. e disease was onset 2 months to 60 months ago, with the mass occupying the lacrimal gland area without obvious pain, accompanied by eyelid swelling, ptosis of the upper eyelid, and partial invasion of the eye muscle leading to restricted eye movement and diplopia in all cases
Summary
To explore the clinical manifestations, imaging characteristics, and pathological characteristics of Castleman’s disease of the lacrimal gland, enhance the knowledge of the disease, and improve the level of its diagnosis and treatment. All the 5 patients were confirmed by pathological examination. Clinical manifestations were characterized by mass occupying lesions in the lacrimal gland area, without obvious pain, accompanied by eyelid swelling and ptosis, as well as space-occupying symptoms. Imaging examination showed that there was a soft tissue mass in the enlarged lacrimal gland area, and the mass was rich in blood flows while showing no obvious specificity, which could invade the surrounding muscles. Castleman’s disease of the lacrimal gland is a rare orbital lymphoproliferative disease lacking specificity in clinical manifestations and imaging examination. E disease is mainly treated with surgical resection, and the pathological type is determined postoperatively As there are difficulties in differentiating the disease from orbital inflammatory pseudotumor and orbital lymphoma, its diagnosis still depends on pathological examination. e disease is mainly treated with surgical resection, and the pathological type is determined postoperatively
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