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TitleLocalized amyloidosis involving lacrimal gland and conjunctiva in Sjogren syndrome
Accept poster if oral is not possible ?Yes
PurposeTo report localized amyloidosis involving the lacrimal gland and conjunctiva in a patient with Sjogren syndrome (SS).

MethodsA 56-year-old female had SS from twenty years ago. The patient suffered from upper eyelid swelling in her left eye for five months. She was referred for managements of a mass OS observed in a nearby clinic in October 2018. Her visual acuity was 20/20 OS with a normal intraocular pressure. Superficial punctate keratopathy (SPK) was seen at the lower part in both eyes, and Schirmer’s test was positive (R=2mm, L=3mm). We conducted an insertion of lacrimal plug. Orbital computed tomography (CT) showed a mild enlargement of the left lacrimal gland. We conducted an excisional biopsy of the lacrimal gland mass after informed consent was obtained.
ResultsHistopathologic examination showed the deposition of amorphous eosinophilic substance not only in the lacrimal gland but also beneath the conjunctival epithelium that demonstrated birefringence of apple-green color on Direct Fast Scarlet (DFS) staining, suggestive of amyloid under a polarizing microscope. The patient referred to the department for additional evaluation for amyloidosis, and was diagnosed with localized secondary amyloidosis of the lacrimal gland.

ConclusionPhysicians should be aware of the existence of amyloidosis in a case of upper eyelid swelling with SS.
Conflict of interestNo
Author 1
Last nameITO
Initials of first name(s)T
DepartmentOphthalmology, Hokkaido University
CitySapporo
CountryJapan
Author 2
Last nameKase
Initials of first name(s)S
DepartmentOphthalmology, Hokkaido University
CitySapporo
CountryJapan
Author 3
Last nameIshijima
Initials of first name(s)K
DepartmentOphthalmology, Hokkaido University
CitySapporo
CountryJapan
Author 4
Last nameSuimon
Initials of first name(s)Y
DepartmentOphthalmology, Hokkaido University
CitySapporo
CountryJapan
Author 5
Last nameTakakuwa
Initials of first name(s)E
DepartmentPathology, Hokkaido University
CitySapporo
CountryJapan
Author 6
Last nameIshida
Initials of first name(s)S
DepartmentOphthalmology, Hokkaido University
CitySapporo
CountryJapan