What are the common lesions of the lacrimal gland, and how can they be differentiated radiologically and clinically?

Inflammatory lesions include sarcoidosis and Sjögren syndrome, often presenting with bilateral enlargement and associated systemic symptoms. Neoplastic lesions, such as pleomorphic adenoma (mixed-cell tumor) and adenoid cystic carcinoma, typically present as unilateral masses, with the latter often showing bone invasion on imaging. Lymphoma may appear as a homogeneous mass and should be considered in patients with systemic lymphadenopathy. Pseudotumor, or idiopathic orbital inflammation, can mimic neoplastic processes but often responds to steroids. Dermoid cysts are characterized by a fat-fluid level on imaging. Key diagnostic features include the lesion's laterality, associated systemic symptoms, and specific imaging characteristics. A common pitfall is mistaking pseudotumor for a neoplastic process without considering steroid responsiveness.