醫源性淚小管肉芽腫－病例報告

Iatrogenic Lacrimal Canalicular Granuloma-A Case Report

林明慧(Ming-Huei Lin) ； 尤之浩(Jy-Haw Yu) ； 沈劍西(Chien-His Shen)

《中華民國眼科醫學會雜誌》 40卷1期 (2001/03) Pp. 96-100

https://doi.org/10.30048/ACTASOS.200103.0016

摘要

本病例報告一位二十五歲女性，因右眼常溢淚求診，懷疑為鼻淚管狹窄(stenosis)，故施行淚囊冲洗(irrigation)及探針探索(probing)，診斷為鼻淚管狹窄並未完全阻塞(stenosis without total obstruction)。經一個多月後回診，發現右下淚孔(lacrimal punctum)長出一直徑約0.5公分突出之肉瘤，手術切除後，病理切片結果為發炎性肉芽腫(granuloma)。推測可能由於施行探針探索(probing)造成淚小管(canaliculus)醫源性傷害(iatrogenic trauma)致使淚管組織發炎，而產生肉芽腫(granuloma)。追蹤6個月後，並無復發現象。探針探索為門診常用的診斷步驟，用來定位淚道系統中阻塞的部位與淚孔距離多遠，以判定何處阻塞，也常用來治療先天性鼻淚管阻塞的幼兒。應小心施行，以免造成醫源性傷害，引起一些不必要的後遺症。

並列摘要

This article describes an uncommon case of granuloma of lacrimal canaliculus. A 25-year-old-women had the symptom of epiphora of right eye, then lacrimal sac irrigation and probing were performed. Nasolacrimal stenosis without total obstruction was diagnosed. One month later, a protruding, flesh-colored mass (about 0.5cm × 0.4cm × 0.3cm) developed from right inferior lacrimal punctum. Excisional biopsy was done and pathology showed inflammatory granuloma of lacrimal canal iculus. Lamina propria beneath the lacrimal canaliculus is moderately infiltrated by lymphocytes and plasma cells. No recurrence was noted by 6-month follow-up. Iatrogenic trauma to lacrimal canaliculus by previous probing should be considered as the most possible cause.

並列關鍵字

probing ； lacrimal punctum ； granuloma ； iatrogenic trauma