Pigmentation of the Lacrimal Sac Epithelium

Ophthalmic Plastic and Reconstructive Surgery
Frederick A JakobiecMichael K Yoon

Abstract

To describe the patterns of the melanocytic populations of 3 cases of lacrimal sac benign melanosis and 1 of atypical primary-acquired sac melanosis with a melanomatous nodule secondary to spread of atypical conjunctival primary-acquired melanosis to the sac. Clinical records, photographs, and paraffin sections stained with hematoxylin and eosin and the Fontana reaction were critically reviewed. Additional sections were immunoreacted for melanoma antigen recognized by T cells and microphthalmia-associated transcription factor. Five nonpigmented pterygia and 4 nonpigmented lacrimal sacs served as controls. Three patients with obstructive dacryocystitis and benign melanosis were African-Americans whose sacs disclosed the presence of nonclustering, melanoma antigen recognized by T cells, and microphthalmia-associated transcription factor-positive intraepithelial dendritic melanocytes at all levels of the epithelium. The transferred melanin granules were concentrated in the adlumenal apical region of the epithelial cells. No fusiform melanocytes were found in the lamina propria. The fourth patient, a white, had atypical conjunctival and sac primary-acquired melanosis and conjunctival and sac melanomas. The intraepithelial sac melan...Continue Reading

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Citations

Nov 12, 2015·American Journal of Ophthalmology·Frederick A Jakobiec
Apr 19, 2020·Survey of Ophthalmology·Ingvild RambergSteffen Heegaard
Oct 21, 2020·Ophthalmic Plastic and Reconstructive Surgery·George SalloumKelly R Everman

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