眼科

• 论著 • 上一篇    下一篇

拟诊双眼泪腺脱垂疾病的临床病理分析

赵红姝 史季桐   

  1. 100730首都医科大学附属北京同仁医院 北京同仁眼科中心 眼科学与视觉科学北京市重点实验室
  • 收稿日期:2016-05-01 出版日期:2016-08-25 发布日期:2016-08-02
  • 通讯作者: 史季桐,Email:Shijt168@163.com

Clinicopathological analysis of lacrimal gland prolapse diosrders

ZHAO Hong-shu, SHI Ji-tong.   

  1. Beijing Tongren Eye center, Beijing Tongren Hospital, Capital Medical University; Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing 100730, China
  • Received:2016-05-01 Online:2016-08-25 Published:2016-08-02
  • Contact: SHI Ji-tong, Email: shijt168@163.com

摘要: 目的 分析拟诊双眼泪腺脱垂疾病的组织病理学特征。设计 回顾性病例系列。研究对象 2010-2015年拟诊双眼泪腺脱垂经北京同仁医院手术治疗与病理诊断的患者58例。方法 回顾患者的病史、症状、眼眶CT、MRI影像学资料及组织病理学资料。主要指标 组织病理学诊断及特征。结果 58例患者中双眼泪腺脱垂36例(62.06%),其他泪腺疾病22例(37.93%)。36例泪腺脱垂患者中病理改变为局灶性淋巴细胞浸润者25例(69.44%),泪腺无明显病理变化者11例(30.56%)。58例患者中局灶状淋巴细胞浸润者25例(43.10%),Mikulicz病18例(31.03%),泪腺炎型炎性假瘤3例(5.17%),粘膜相关淋巴组织边缘带B细胞淋巴瘤(MALT-EMZL)1例(1.72%),泪腺无明显病理变化者11例(18.96%)。结论 双眼泪腺脱垂患者应与泪腺炎型炎性假瘤、早期Mikulicz病和泪腺MALT-EMZL鉴别。三分之二的双眼泪腺脱垂患者中泪腺发生不同程度的局灶性淋巴细胞浸润改变。(眼科, 2016, 25: 251-255)

关键词: 泪腺脱垂/病理学, 炎性假瘤, Mikulicz病, 淋巴瘤

Abstract: Objective To analyze histopathological characteristics and types of bilateral lacrimal gland prolapsed disorders. Design Retrospective case series. Participants 58 patients with bilateral lacrimal gland prolapsed disorders were surgically treated and were diagnosed pathologically in Beijing Tongren Hospital from 2010 to 2015. Methods The patients’ case history, symptoms, orbital imaging data of CT, MRI and the histopathological data were reviewed. Main Outcome Measures Pathological diagnosis. Results Of the 58 patients 36 (62.06%) were diagnosed as bilateral lacrimal gland prolapse, 22 cases (37.93%) had other lacrimal gland disorders. Of the 36 patients with lacrimal gland prolapsed, 25 cases (69.44%) had the pathological changes of focal lymphocytic infiltration, 11 cases (30.56%) had no evident pathological changes. Among all the 58 patients with bilateral lacrimal disorders, 25 cases (43.10%) had focal lymphocytic infiltration, 18 cases (31.03%) had Mikulicz disease, 3 cases (5.17%) had the subset of dacryoadenitis attributed to idiopathic orbital inflammation, 1 case (1.72%) had extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT-EMZL), and 11 cases (18.96%) had no significant changes in lacrimal tissue. Conclusion The bilateral lacrimal gland prolapse disorders should differentiated from the subset of dacryoadenitis attributed to idiopathic orbital inflammation, early stage Mikulicz disease and MALT-EMZL at the lacrimal gland area. Of the patients with bilateral lacrimal gland prolapse, two-thirds of the patients’ lacrimal glands had focal lymphocytic infiltration changes to different extents. (Ophthalmol CHN, 2016, 25: 251-255)

Key words: lacrimal gland prolapse/ pathology, idiopathic orbital inflammation, Mikulicz disease, lymphoma