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눈물주머니에 발생한 면역글로불린 G4 연관 염증성 낭종 1예

IgG4-related Inflammatory Cyst of Lacrimal Sac

검안 및 콘택트렌즈학회지 2017년 16권 3호 p.115 ~ 119
박혜인, 이강원, 주영채, 강성모,
소속 상세정보
박혜인 ( Park Hye-In ) - 인하대학교 의과대학 인하대학교병원 안과학교실
이강원 ( Lee Kang-Won ) - 인하대학교 의과대학 인하대학교병원 안과학교실
주영채 ( Chu Young-Chae ) - 인하대학교 의과대학 인하대학교병원 병리과학교실
강성모 ( Kang Sung-Mo ) - 인하대학교 의과대학 인하대학교병원 안과학교실

Abstract


Purpose: The aim of this study is to report a case of IgG4-related inflammatory cyst of lacrimal sac.

Case summary: A 40-year-old female complained of left upper eyelid swelling with redness of duration 18 months. Initial her visual acuity was 20/20 (OD), 20/20 (OS). Swelling with an erythematous lesion was found on the left upper eyelid and an erythematous palpable mass was present at the left medial caruncle. The exophthalmometry exam revealed proptosis of 2.0 mm on the left eye. Computed tomography (CT) depicted a 1.0 × 1.6 × 2.4 cm sized cystic mass on the lacrimal sac extending to the left medial canthus. The patient underwent endoscopic biopsy and dacryocystorhinostomy with silicone tube intubation, and during the surgery, a whitish yellow mucoid discharge drained from the lacrimal sac, which was dense lymphoplasmacytic infiltrates with H&E staining, and many IgG- and IgG4-positive plasma cells were observed in high power fields during anti-IgG and anti-IgG4 antibody examinations. After procedure, orbital mass decreased on CT. After obtaining the pathologic result, serum IgG4 was normal at 68.3 mg/dL (normal range 3.9-86.4 mg/dL) and serum IgG was also normal as 1,285 mg/dL (normal range 870-1,700 mg/dL). The erythrocyte sedimentation rate was 8 mm/hour.

Conclusion: We obtained the pathologic results of lymphoplasmacytic infiltrates and many IgG- and IgG4-positive plasma cells in lacrimal sac, and this case showed IgG4-related disease involved a lacrimal sac and created an inflammatory cyst in the sac initially in Republic of Korea.

키워드

Lacrimal sac; IgG4-related disease

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