112例眼附属器淋巴增生性病变临床组织病理学初步分析  

Clinical and pathological features of 112 cases with ocular adnexal lymphoproliferative lesions

作　　者：游启生[1] 李彬[1] 周小鸽[2] 孙宪丽[1] 安裕志[3] 史季桐[3] 李辽青[1] 高飞[1] 

机构地区：[1]首都医科大学北京同仁眼科中心北京市眼科研究所,100005 [2]首都医科大学附属北京友谊医院病理科 [3]首都医科大学北京同仁眼科中心

出　　处：《中华眼科杂志》2005年第10期871-876,共6页Chinese Journal of Ophthalmology

摘　　要：目的初步探讨眼附属器淋巴增生性病变的发病情况、临床特征以及组织病理学特点和分型。方法收集112例经组织病理学诊断为眼附属器淋巴增生性病变患者的116份石蜡切片标本,分析归纳临床相关资料,进一步分析组织病理学特点,并根据2001年世界卫生组织淋巴及血液组织肿瘤分类方案进行重新分类诊断。结果患者年龄8～80岁,平均49岁。病程20d至22年,平均22个月。双眼患病者16例(14.3%)。临床常见表现为眼球突出、局限性肿块(69例,占61.6%)。组织病理学检查显示反应性淋巴细胞增生11例(9.8%),非典型淋巴细胞增生10例(8.9%),淋巴瘤91例(81.3%)。其中,黏膜相关组织型边缘带B细胞淋巴瘤74例(占淋巴瘤患者81.3%)。结论眼附属器淋巴增生性病变以黏膜相关组织边缘带B细胞淋巴瘤最为多见,好发于中老年人,临床表现为慢性迁延性病程,双眼发病并不少见。Objective To investigate the histopathological classification and clinical features of ocular adnexal lymphoproliferative lesions. Methods The clinical, histomorphological and immunohistochemical features of 112 cases of ocular adnexal lymphoproliferative lesions （116 paraffin specimens） were studied retrospectively. The lesions were classified according to the World Health Organization classification of tumors of haematopoietic and lymphoid tissues （2001）. Results This group of patients＇ ages averaged at 49. The mean duration between the onset of the symptoms and the time of presentation was 22 months. Sixteen patients （ 14.3% ） had bilateral lesions. Proptosis or local orbital mass was presented in 69 cases （61.6%）. Reactive lymphoid hyperplasia was diagnosed in 11 cases （9.8%） and atypical lymphoid hyperplasia in 10 cases （ 8.9% ）. The rest 91 cases （ 81.3% ） were diagnosed as lymphoma, among~ which 74 cases （81.3%） were extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue （MALT-EMZL）. Conclusions MALT-EMZL is the most frequent type of ocular lymphoproliferative lesions in ocular adnexa. The ocular adnexal lymphoproliferative lesions show an indolent course clinically, tending to affect the old. Bilateral case is not uncommon. （Chin J Opbtbalmol, 2005,41. 871-876）

关 键 词：眼肿瘤 淋巴瘤 病理学 临床 淋巴瘤 黏膜相关淋巴样组织 

分 类 号：R777[医药卫生—眼科]