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유루로 내원한 원발성 눈물주머니 결핵 1예

A Case of Primary Tuberculosis of the Lacrimal Sac Presenting as Epiphora

대한이비인후과학회지-두경부외과학 2021년 64권 3호 p.202 ~ 206
이상윤, 박상욱, 이종실, 전영진,
소속 상세정보
이상윤 ( Lee Sang-Yun ) - Gyeongsang National University Hospital Department of Otorhinolaryngology
박상욱 ( Park Sang-Wook ) - Gyeongsang National University Hospital Department of Otorhinolaryngology
이종실 ( Lee Jong-Sil ) - Gyeongsang National University School of Medicine Department of Pathology
전영진 ( Jeon Yung-Jin ) - Gyeongsang National University Hospital Department of Otorhinolaryngology

Abstract


Extra-pulmonary tuberculosis usually progresses as a secondary infection from pulmonary tuberculosis,and tuberculosis of the head and neck region. Tuberculosis of ocular and periocularareas, however, is a rare disease. Among ocular tuberculosis involving the adnexal structures, afew lacrimal sac tuberculosis has been reported. We recently experienced a case of lacrimal sactuberculosis presenting as epiphora. Examination revealed bilateral nasolacrimal duct obstructionand the patient underwent endoscopic endonasal dacryocystorhinostomy. During the operation,a biopsy taken from the unhealthy looking lacrimal sac filled with caseous necrotic tissuewas suggestive of tuberculosis. Histopathological features and further systemic evaluation confirmedtuberculosis. She was treated medically with anti-tubercular agents. The new openingof the lacrimal sac was patent and epiphora was resolved successfully at a year follow up. Thisreport highlights the requirement of high suspicion of tuberculosis, even in the nasolacrimaldrainage system.

키워드

Dacryocystorhinostomy; Epiphora; Lacrimal sac; Nasolacrimal duct; Tuberculosis

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