Tuesday, September 23, 2014

Update: The 12-year-old Jack Russell with the large lacrimal sac swelling

Sep 24, 2014

Update

This is the 3rd case, part of the "trilogy" I saw recently. Or a "trifecta".
The other 2 cases also had swelling on the right side of the face. One is a case of facial cyst. The other is a carnaissal tooth abscess.
 
In this case, no more swelling as at 12th day after I electro-excised the lacrimal sac leaking out the brown fluid. I also electro-excised 2 pieces of tissue, possibly the sac, quite near the nasolacrimal canal. There was no contrast imaging done as that would increase the medical cost. Many Singapore owners want the least medical cost but the medical overheads keep going up nowadays as landlords keep increasing their rentals, knowing that Singapore, like Hongkong, has a shortfall of commercial units for rent.    

This was done after aspiration of 2 ml of brown fluid earlier, using a 1-ml syringe.

LAB TESTS OF LACRIMAL SAC FLUID

1 ml of yellowish fluid.

Microscopic description
3 Pap and one Diff Quik stained smears show a paucicellular yield. Thin degenerate proteinaceous material. No epithelial or malignant cells.

Diagnosis 
LACRIMAL SAC LESION, FNAC
Degenerate cyst contents. pl re-aspirate if there is a residual nodule.

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