Primary Systemic Amyloidosis Involving the Lacrimal Sac

Dear Editor, Amyloidosis is a heterogeneous group of diseases characterized by extracellular amyloid deposits in different organs [1]. Deposition may occur secondary to a systemic disease or as primary amyloidosis in absence of a systemic disease. Periocular and orbital amyloidosis are rare, especially in the lacrimal apparatus. In South Korea, only 12 cases of amyloidosis have been reported, and these mainly concerned involvement of conjunctiva or cornea [2]. This is the first Korean report of a patient with systemic amyloidosis involving the lacrimal sac. An 81-year-old man was referred to our hospital with complaints of tearing in both eyes, tenderness, and swelling in the region overlying the right lacrimal sac. He had a hemato-oncological history of diffuse large B cell lymphoma of the left kidney and a recent history of amyloidosis of the stomach but no ophthalmic disease history. On physical examination, best-corrected visual acuity was 0.5 in the right eye and 0.4 in the left. There was mucoid reflux upon compression, and a soft mass was detected by palpation in the right lacrimal sac area. The tear meniscus was elevated, and impaired clearance of f luorescein dye was noted from the tear film in both eyes. The remainder of the ophthalmic examination was normal. Facial computed tomography revealed swelling of the right medial canthal area and dilatation of both lacrimal sacs with peripheral enhancement of fuzzy margins (Fig. 1A). The patient underKorean J Ophthalmol 2016;30(3):234-235 http://dx.doi.org/10.3341/kjo.2016.30.3.234 Correspondence