Primary non Hodgkin's lymphoma of the lacrimal sac

BACKGROUND Primary non-Hodgkin's lymphoma of the lacrimal sac is extremely rare, with most reported cases representing secondary involvement of a systemic malignancy. METHODS The clinical record of a 70-year-old female who presented with epiphora and swelling of the lacrimal sac area is described. A review of the literature of patients with primary lacrimal sac lymphoma also is presented. RESULTS Computed tomography demonstrated a lacrimal sac mass involving the nasolacrimal canal. Histopathologic examination of a biopsy specimen revealed a diffuse large cell lymphoma. Using immunohistologic staining, the tumor was a B-cell type, similar to those described in the literature. The patient was treated with 50 gray of irradiation and chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisone. The patient remained free of lymphoma 26 months after initial treatment. An ocular examination was unremarkable except for epiphora. CONCLUSIONS Radiotherapy and/or chemotherapy can treat localized lymphoma of the lacrimal sac successfully.