眼睑和眼眶血管平滑肌瘤的临床病理学特点  

Clinicopathologic characteristics of angioleiomyoma of the eyelids and orbit

作　　者：林锦镛[1] 赵红[1] 杨振海[1] 王玉川[1] 张蕾[1] 

机构地区：[1]天津市眼科医院天津医科大学眼科临床学院天津市眼科研究所天津市眼科学术视觉科学重点实验室,300020

出　　处：《中华眼科杂志》2015年第8期586-591,共6页Chinese Journal of Ophthalmology

摘　　要：目的 分析眼睑和眼眶血管平滑肌瘤的临床与病理学特点.方法 回顾性系列病例研究.收集天津市眼科医院2005年1月至2014年4月收治的2例眼睑和6例眼眶血管平滑肌瘤患者的临床资料,包括患者年龄、性别、临床表现、CT检查、彩色多普勒超声检查和治疗方法等.结果 8例患者中,男性5例,女性3例,年龄32.0 ～ 65.0岁,年龄中位数为52.5岁.2例发生于眼睑内侧皮下;6例发生于眼眶内,其中3例位于眼眶肌锥内,2例位于眼眶下方,1例位于眼眶外上方.7例为单发性肿瘤,1例眼眶血管平滑肌瘤伴发同侧下眼睑海绵状血管瘤.彩色多普勒超声检查显示肿瘤边界清楚,内回声均匀,无明显血流信号.CT检查显示肿瘤呈椭圆形或不规则形状的软组织团块影,密度比较均匀,边界清楚,CT值为45～50 Hu,部分肿瘤压迫邻近组织或视神经.肿瘤大体呈圆形或不规则椭圆形,体积为0.7～2.8cm,边界清楚,6例有较完整的包膜.肿瘤实质主要由分化成熟的平滑肌细胞和厚壁血管组成,其中5例为海绵状型,2例为静脉型,1例为实体型.免疫组织化学染色显示血管壁周围和血管之间的平滑肌纤维对SMA和Desmin呈阳性表达.8例患者均施行肿物完整切除术,术中可见肿瘤边界清楚,有包膜,与周围组织有轻度粘连.结论 眼睑或眼眶血管平滑肌瘤是非常少见的良性肿瘤,多发生于成年人,肿瘤有完整包膜,主要由多数厚壁血管和平滑肌组成.对边界清楚的眼眶内肿物应考虑到本瘤的可能性.病理诊断中应当注意与平滑肌瘤或海绵状血管瘤鉴别.Objective To analyze the clinical pathologic characteristics of angioleiomyoma of the eyelid and orbit.Methods Retrospective case series study.The clinical and pathological characteristics of 8 cases of eyelid and orbital angioleiomyoma which were treated in Tianjin Eye Hospital from January 2005 to April 2014 were reviewed and analyzed.Results In the 8 cases,5 were male and 3 were female.The median age was 52.5 years （32.0 to 65.0）.Six cases of angioleiomyoma occurred in the orbit.Three of them located in the muscle cone,2 of them located in superotemporal orbit and 1 of them located in the inferior orbit.The remaining 2 cases of angioleiomyoma occurred in the medial side of the eyelid subcutanously.Five cases were male and three cases were female.Seven cases revealed a solitary eyelid or orbital mass.One case of orbital angioleiomyoma companied with a cavernous hemangioma of ipsilateral lower eyelid.The color Doppler ultrasound of the orbit showed a well-demarcated mass with homogeneous inner-echoes without obviously blood stream signal The CT showed a circumscribing rounded or irregular shaped soft mass with isotropic density and the CT value were 45 to 50 Hu.Grossly,the tumor appeared as a rounded or irregular oval ranged from 0.7 to 2.8 cm.Six cases had complete fibrous capsule.Microscopically,the tumor was mainly consisted of well-differentiated smooth muscle cells and thick-walled vessels.Five cases were cavernous type,two cases were venous type and one case was solid type according to histological classification.The smooth muscle cells surrounding the vascular walls and the intervascular muscle bundles showed a positive reaction for smooth muscle actin （SMA） and desmin by immunohistochemical staining.Eight patients underwent complete resection of mass.During the surgery,the tumor was observed with clear boundary and capsule surrounded by mild adhesive tissue.Conclusions Angioleiomyoma of the eyelids or orbit was a uncommon benign tumor which was usually occured in adults,with well-encapsulated and

关 键 词：眼睑肿瘤 眶肿瘤 血管肌瘤 

分 类 号：R739.7[医药卫生—肿瘤]