The lacrimal gland is a small gland located within lacrimal fossa of the frontal bone. Due to different types of cells seen in lacrimal gland, the differential diagnosis of lacrimal gland enlargement includes a variety of disorders. This is the first study in Iran to determine the relationship between clinical, radiological and histopathological features of lacrimal gland enlargement.

The study is a retrospective review of demographic data of patients with lacrimal gland enlargement, their facial photographs, orbital CT-scans, and histopathological findings from lacrimal gland biopsies in Farabi Eye Hospital between 2012 and 2017.

Forty seven patients were included in this study (15 men and 32 women) with median age of 37.9 years (range, 15- 79 years). Histopathologic diagnoses included chronic dacryoadenitis in 20 samples (42.55%), orbital pseudotumor in 7 (14.89%), IgG4-related disease in 6 samples (12.77%), non-necrotizing granulomatous inflammation, B-cell lymphoma, adenoid cystic carcinoma and mixed tumor each in 2 (4.26%), followed by single instances (2.13%) of acute dacryoadenitis, conjunctival epithelial cyst and fibrofatty tissue. In two samples the biopsy revealed normal lacrimal glands (4.26%). Interestingly, two cases had different histopathologic diagnosis in biopsies taken from each lacrimal gland at different times.

It is difficult to distinguish the type of the lacrimal gland lesion solely by clinical picture, so tissue biopsy is often needed. In our series, chronic dacryoadenitis was most commonly encountered, followed by orbital pseudotumor and IgG4-related disease.