Diagnostic Value of Incisional Biopsies in Lacrimal Gland Lesions: A 10-Year Single-Center Experience

Purpose To evaluate the histopathological findings and diagnostic value of incisional biopsies in patients with lacrimal gland lesions at a German university hospital over a 10-year period. Methods We conducted a retrospective analysis of clinical records and histopathological findings from 15 patients who underwent incisional lacrimal gland biopsies between February 2013 and October 2023. Patient demographics, clinical presentation, histopathological diagnoses, and subsequent management were recorded and analyzed. Results The cohort included 15 patients (13 females, 2 males) with a mean age of 48.8 ± 23.1 years (range: 6–90 years). Histopathological examination revealed dacryoadenitis in 10 patients (73.4%), marginal zone lymphoma in 3 patients (20%), and non-specific findings consistent with lacrimal gland prolapse in 1 patient (6.7%). Among the dacryoadenitis cases, specific etiologies included IgG4-related disease (n = 2), sarcoidosis (n = 2), tuberculosis (n = 1), and idiopathic inflammation (n = 6). In 7 patients (46.7%), the biopsy established the diagnosis of a previously unrecognized systemic condition. Conclusion Incisional biopsies of lacrimal gland lesions provide valuable diagnostic information that guides appropriate management. While inflammatory conditions represent the majority of cases, a significant proportion of patients have neoplastic lesions requiring specialized treatment. Lacrimal gland biopsies frequently lead to the diagnosis of underlying systemic diseases, highlighting their value in the diagnostic workup of lacrimal gland enlargement.