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We report three cases of adult lacrimal gland xanthoganulomatous disease that demonstrate the spectrum of this disorder and provide insight into immune dysfunction.
Case 1
A 23 year old asthmatic female had 1 year of bilateral, painless, lacrimal gland masses from polyclonal B cell (CD 20+) infiltration (fig 1A, B) The patient was asymptomatic for 18 months after external beam radiation (25 Gy in 10 fractions). While 7 months pregnant, painless lacrimal gland enlargement recurred, as firm, yellow, nodular masses (fig 1C). A second biopsy showed foamy histiocytes, Touton giant cells, and lymphoid infiltrate without necrobiosis (fig 1D). The orbital masses have remained stable 2 years after corticosteroids and surgical debulking. Systemic involvement included breast MALT type lymphoma 4 years after presentation.
Case 2
A 49 year old Brunei …