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Photos courtesy of: Bita Esmaeli, M.D. / M.D. Anderson Cancer Center
Used with permission. Not to be reproduced.

A 45-year-old man had a left lacrimal sac malignant mass evaluated by MRI.

1.	The epithelium that lines the lacrimal sac is:
	b -- pseudostratified columnar The lacrimal sac and nasolocarimal duct are both lined by pseudostratified columnar epithelium resembling respiratory epithelium, while the punctum and canaliculus is lined by nonkeratinized stratified squamous epithelium.
2.	Symptoms that would be concerning for malignancy include:
	a -- blood tinged epiphora Patients presenting with bloody tears should raise the suspicion of a malignancy in the nasolacrimal outflow pathway. Inferonasal dystopia may be seen with lacrimal gland malignancy.
3.	The most common lacrimal sac malignancy is:
	b -- squamous cell carcinoma The most common lacrimal sac malignancy is squamous cell carcinoma. Adenoid cystic carcinoma is the most common primary epithelial lacrimal gland malignancy.