The Radiological Spectrum of Orbital Pathologies that Involve the Lacrimal Gland and the Lacrimal Fossa

Abstract

CT and MRI are utilized to differentiate between different types of masses and to determine the extent of lesions involving the lacrimal gland and the fossa. Although many diseases that affect the lacrimal gland and fossa are specifically diagnosed by imaging, it is frequently very difficult to differentiate each specific disease on the basis of image characteristics alone due to intrinsic similarities. In lacrimal gland epithelial tumors, benign pleomorphic adenomas are seen most commonly with a well defined benign appearance, and a malignant adenoid cystic carcinoma is seen with a typical invasive malignant appearance. However, a malignant myoepithelial carcinoma is seen with a benign looking appearance. Lymphomatous lesions of the lacrimal gland include a broad spectrum ranging from reactive hyperplasia to malignant lymphoma. These lesions can be very difficult to differentiate both radiologically and pathologically. Generally, lymphomas tend to occur in older patients. The developmental cystic lesions found in the lacrimal fossa such as dermoid and epidermoid cysts can be diagnosed when the cyst involves the superior temporal quadrant of the orbit and manifests as a non-enhancing cystic mass and, in case of a lipoma, it is diagnosed as a total fatty mass. However, masses of granulocytic sarcoma and xanthogranuloma, as well as vascular masses, such as a hemangiopericytoma, are difficult to diagnose correctly on the basis of preoperative imaging findings alone. A careful clinical evaluation and moreover, a pathologic verification, are needed. In this pictorial review, the various imaging spectrums of pathologic masses involving the lacrimal gland and fossa are presented, along with appropriate anatomy and pathology reviews.

Evaluation of Lacrimal Gland Dimensions and Volume in Turkish Population with Computed Tomography

“…Both magnetic resonance imaging (MRI) and CT can be used effectively for detection of LG pathologies [3,[8][9][10]. It is important to reveal the anatomic characteristics of LGs because much pathology such as sarcoidosis, Sjögren disease, thyroid ophthalmopathy, benign and malign tumors manifest with changes in LG sizes [3,9,10].…”

“…The LG is a target tissue especially in autoimmune and granulomatous diseases. Changes in LG size may be helpful in diagnosis of these atypical and difficultly identified pathologies [2,3]. Therefore evaluating the LG sizes in computed tomography (CT) scan which is an accessible and widespread method in head and neck imaging, may enable early diagnosis and treatment of mentioned pathologies [4].…”

Структура Та Клінічні Прояви Пухлин Різної гістологічної Структури Краніоорбітальної Ділянки Та Орбіти

“…Епітеліальні Îðèã³íàëüí³ äîñë³äaeåííÿ /Original Researches/ становлять 40-50 % з усіх новоутворень слізної залози і значною мірою є неопластичними [18]. Неепітеліальні процеси бувають переважно запальними (дакріоаденіт), а також неопластичними (лімфопроліферативне утво-рення) [13]. Плеоморфна аденома (5 спостережень) є найбільш поширеною доброякісною епітеліальною пухлиною слізної залози, що містить як мезенхімальні, так і епі-теліальні елементи.…”

“…При КТ і МРТ поліморфна аденома виглядає як чітко окреслене, гомогенне утво-рення у верхньоскроневій ділянці орбіти. Інфільтратив-ний кордон і кулеподібність повинні викликати підозру на злоякісність [13].…”

Cancer around the brain

“…7 In rare cases, dural metastases can appear in the posterior fossa and thus resemble meningioma. A number of tumors spread through cavities such as the nasal cavity, the orbit, 8 the oral cavity, and the soft palate 9 as well as through other locations including the eyelids, 10 the lacrimal glands, the parotid, and several locations in the neck. 11 These tumors, in addition to causing symptoms as a consequence of compression, can invade or spread into CNs either anteriorly or in a retrograde fashion.…”