—We appreciate Dr Bartley's comments concerning our report1 of a 17-year-old girl with massive enlargement of the lacrimal collecting system demonstrated with magnetic resonance images. Examination of biopsy specimens revealed sinus histiocytosis intrinsic to the lacrimal sac and nasolacrimal duct in a patient whose disease was limited to these structures and the upper respiratory tract. Dr Bartley cites two other articles in which epiphora is mentioned as a symptom in patients with ophthalmic or orbital involvement by this disease.2,3 While we are aware of these reports, and cited the former in our article for other reasons, we do not believe that their authors posited direct infiltration of the lacrimal drainage systems by sinus histiocytosis as an explanation for the epiphora. Clearly, neither report included the evidence that would support such a proposal.In the study by Foucar et al,2 sinus histiocytosis involved the orbit alone
Dolman PJ, Harris GJ, Weiland LH. Sinus Histiocytosis Involving the Lacrimal Sac and Duct-Reply. Arch Ophthalmol. 1992;110(4):448–449. doi:10.1001/archopht.1992.01080160026008
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