Female, 54 years old, with lacrimal gland enlargement. The left lacrimal gland is enlarged relative to the right. However, both lacrimal glands demonstrate similar T2 signal characteristics with only slightly more heterogeneity on the left. No discrete solid or cystic lesion is identified. Enhancement of both lacrimal glands is solid and fairly homogeneous. There are no findings to suggest significant inflammation in the adjacent orbital soft tissues. The extraocular muscles, optic nerve, orbital fat and globe are all within normal limits. Mucosal thickening and evidence for osteogenesis are demonstrated in the right maxillary sinus.
Enlargement of the left lacrimal gland is seen without evidence for a discrete underlying cystic or solid lesion. The differential diagnosis would include inflammation, including idiopathic orbital inflammation (orbital pseudotumor), infectious or postinfectious processes, a manifestation of granulomatous or connective tissue disease. The possibility of a lacrimal gland tumor would remain in the differential as well.