Dr.INDU B. NARAYANAN

Dr.ANN J.K., Dr.Ani Sreedhar

Abstract

Various causes of bilateral lacrimal gland enlargement includes inflammatory and lymphoproliferative lesions.Major etiologies being sarcoidosis,sjogrens, IgG4 sclerosing orbital disease,lymphoma.We present a rare case of amyloidosis,secondary to orbital lymphoma.

62 year old man presented with bilateral lacrimal gland enlargement of 5 months duration.CT orbit showed bulky irregular lacrimal glands,with homogenous enhancement and calcification.Lateral orbitotmy with excision biopsy was done.Histopathology reported amyloidosis with classical apple birefringence on polarised light.Myeloma work up was negative.Immunohistochemistry revealed low grade Bcell lymphoma.CT abdomen revealed abdominal lymph nodes involvement.Bone marow biopsy showed infiltrates.Patient has been started on chemotherapy and is under follow up.

Even though majority of cases of lacrimal gland amyloidosis is localised,bilateral lacrimal gland involvement has to be thoroughly evaluated in search of the real culprit.