Lacrimal sac lymphoma: A series of Japanese patients

Eur J Ophthalmol. 2019 Nov;29(6):678-684. doi: 10.1177/1120672118803510. Epub 2018 Oct 1.


Purpose: To present cases of primary lacrimal sac lymphoma in a Japanese population.

Methods: In this retrospective case series, five cases (two males and three females; mean age: 49.8 years; age range: 38-62 years) were included. Clinical features, diagnostic findings, and treatment outcomes were collected and reviewed.

Results: Most patients presented with a swelling or mass in the medial canthal area. Only one patient presented with epiphora, while another patient also complained of pain which was due to inflammation. Imaging studies revealed a lacrimal sac mass with involvement of the nasolacrimal duct and variable involvement of the nasal cavity. Histopathological findings revealed three cases of diffuse large B-cell lymphoma, one case of extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue, and one case of follicular lymphoma. Four cases were treated with a combination of chemotherapy and immunotherapy, with one case necessitating additional radiotherapy. One case was treated with immunotherapy alone. The mean follow-up was 23 (range: 3-50) months. Four cases showed complete remission, while the remaining patient is still ongoing treatment.

Conclusion: Diffuse large B-cell lymphoma is the most common type of lacrimal sac lymphoma in this series. Lacrimal sac tumors should be ruled out in the presence of epiphora, dacryocystitis, or a mass in the medial canthus, even in the absence of pain or bleeding. Combined chemotherapy and immunotherapy is an effective treatment for these cases.

Keywords: Japanese; Lacrimal sac lymphoma; diffuse large B-cell lymphoma; follicular lymphoma; mucosa-associated lymphoid tissue.

MeSH terms

  • Adult
  • Antineoplastic Agents / therapeutic use
  • Combined Modality Therapy
  • Eye Neoplasms / diagnostic imaging
  • Eye Neoplasms / pathology*
  • Eye Neoplasms / therapy
  • Female
  • Humans
  • Immunotherapy
  • Lacrimal Apparatus Diseases / diagnostic imaging
  • Lacrimal Apparatus Diseases / pathology*
  • Lacrimal Apparatus Diseases / therapy
  • Lymphoma, B-Cell, Marginal Zone / diagnostic imaging
  • Lymphoma, B-Cell, Marginal Zone / pathology*
  • Lymphoma, B-Cell, Marginal Zone / therapy
  • Lymphoma, Follicular / diagnostic imaging
  • Lymphoma, Follicular / pathology*
  • Lymphoma, Follicular / therapy
  • Lymphoma, Large B-Cell, Diffuse / diagnostic imaging
  • Lymphoma, Large B-Cell, Diffuse / pathology*
  • Lymphoma, Large B-Cell, Diffuse / therapy
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Radiotherapy
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Treatment Outcome


  • Antineoplastic Agents