32 A variety of lesions can present as masses of the lacrimal gland and lacrimal fossa. Lesions are generally divided into epithelial and nonepithelial lesions. Epithelial lesions include the majority of neoplasms except lymphomas. Nonepithelial lesions are lymphoma and lymphoproliferative lesions, as well as other inflammatory processes. The neoplasms that involve the lacrimal gland are similar to lesions involving the salivary glands. Pleomorphic adenoma (benign mixed tumor, BMT) is the most common tumor. Adenoid cystic carcinoma is the most common epithelial malignancy, and is often painful, whereas BMT is generally painless. Lymphoma is the most common nonepithelial malignancy. Inflammatory and lymphoproliferative lesions make up the majority of other lesions. It is not possible to differentiate benign and malignant processes on imaging alone, and resection or biopsy may be necessary (Table 32.1).
Lacrimal Gland Lesions
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