45例腮腺囊肿临床病理分析  

Clinico-pathological analysis of 45 parotid gland cysts

作　　者：王智明[1] 叶明[1,2] 杨东升[1] 马颖[3] 苏欣[3] 张维庆[1] 潘遥 关乔丹 

机构地区：[1]中国医科大学附属盛京医院口腔颌面外科,辽宁沈阳110004 [2]抚顺矿务局总医院口腔科,辽宁抚顺113008 [3]中国医科大学附属盛京医院病理科,辽宁沈阳110004

出　　处：《上海口腔医学》2016年第2期199-203,共5页Shanghai Journal of Stomatology

基　　金：辽宁省科学技术计划资助项目(2012225100)

摘　　要：目的:探讨腮腺囊肿的临床病理特点和治疗方法。方法:选取2000年1月—2014年6月中国医科大学附属盛京医院口腔颌面外科45例腮腺肿物切除患者,术后病理确诊为腮腺囊肿。回顾分析不同腮腺囊肿的临床病理特点。结果:男25例,女20例,中位年龄51岁。囊肿位于左侧腮腺21例,右侧腮腺24例。临床症状以腮腺区无痛性肿大为主,囊肿大小0.8 cm×0.6 cm×0.5 cm^10 cm×2.8 cm×0.6 cm。腮腺囊肿伴疼痛9例,无疼痛36例;腮腺囊肿伴淋巴结肿大4例,无淋巴结肿大41例。治疗以单纯腮腺囊肿切除为主,术后均无面神经损伤。随访1~10 a,未见复发。45例术后经组织病理学检查,单纯性囊肿29例(64.4%),表皮样囊肿9例(20%),淋巴上皮囊肿7例(15.6%)。除常见的病理表现外,镜下还可见一些非特异性改变,例如腮腺囊肿伴纤维组织瘤样增生,腮腺囊肿伴炎症,腮腺囊肿伴钙化,腮腺囊肿伴滑膜囊肿样改变,腮腺囊肿伴异物巨细胞反应,腮腺囊肿伴肉芽肿样改变。结论:腮腺囊肿的症状以渐进性肿大为主,治疗以单纯囊肿切除为主,无面神经损伤,无复发。病理类型主要为单纯性囊肿、淋巴上皮囊肿和表皮样囊肿。PURPOSE： To discuss the clinical and pathological characteristics and management of parotid gland cyst.METHODS： Forty-five resected samples of parotid gland tumors were selected from Shengjing Hospital of China Medical University from January 2000 to June 2014 whose postoperative pathological diagnosis were parotid gland cysts. The clinico-pathological characteristics in different types of parotid gland cysts were analyzed. RESULTS： Of 45 cases of parotid gland cyst, 25 were males, 20 were females. The median age was 51 years old. 21 cases were located on the left side of parotid gland, while 24 on the right side. The main clinical symptom was painless swelling in parotid gland region.The sizes varied from 0.8 cm×0.6 cm×0.5 cm to 10 cm×2.8 cm×0.6 cm. Nine cases were accompanied with pain, and 36 without. 4 cases were seen with lymph node enlargement, and 41 without pain. The main treatment modality was simple resection of cyst without any injury of facial nerve. No recurrence was seen after following up for 1-10 years. Of the 45 postoperative histopathological results, 29 cases（64.4%） were simple cysts, 9 cases（20.0%） were polycystic disease cysts,and 7 cases（15.6%） were lymphoepithelial cysts. Besides the above-stated pathological manifestations, some non-specific microscopic changes were accompanied with parotid gland cysts, including tumor-like hyperplasia of fibrous tissue,inflammations, calcifications, synovial cyst-like changes, foreign-body giant cell reactions and granulomatous changes.CONCLUSIONS： The main symptom of parotid gland cyst is progressive enlargement, and simple resection of cyst is the first-line treatment without facial nerve injury or reoccurrence. The main pathological classifications are simple cysts,lymphoepithelial cysts and polycystic disease cysts.

关 键 词：腮腺 囊肿 组织病理学 

分 类 号：R739.87[医药卫生—肿瘤]