泪腺区占位性病变91例临床发病特点与组织病理学分析  

Clinical features and pathological analysis of lacrimal gland occupying lesions in 91 cases

作　　者：陶涛[1] 杨极 刘海[1] 杨扬[1] 张乾 方成彦[1] 杨忠昆[1] 胡竹林[1] Tao Tao;Yang Ji;Liu Hai;Yang Yang;Zhang Qian;Fang Chengyan;Yang Zhongkun;Hu Zhulin(Department of Ophthalmology,the Second People′s Hospital of Yunnan Province,Yunnan Clinical Medical Research Center of Eye Diseases,Yunnan Clinical Medical Center of Eye Diseases,Kunming 650021,China)

机构地区：[1]云南省第二人民医院眼科,云南省眼部疾病临床医学研究中心,云南省眼病临床医学中心,昆明650021

出　　处：《中华眼科杂志》2019年第11期842-846,共5页Chinese Journal of Ophthalmology

基　　金：云南省科技计划项目重大科技专项(2018ZF009);云南省卫生科技计划项目(2018NS0012)。

摘　　要：目的分析泪腺区占位性病变的发病特点及组织病理学特点分布。方法回顾性系列病例研究。选取2014年1月至2018年11月收住云南省第二人民医院眼科行手术治疗的泪腺区占位性病变91例(102只眼)患者的临床资料,所有患者均有1种以上影像学检查结果及组织病理学诊断结果。分析患者的年龄、就诊原因、性别、影像学检查资料和组织病理学诊断结果。结果91例患者中男性46例(50.5%),女性45例(49.5%),年龄1岁1个月至72岁,平均年龄43岁。良性肿瘤共58例(63.7%),发病前3位的是多形性腺瘤43例(47.3%)、皮样囊肿6例(6.6%)、炎性假瘤6例(6.6%);恶性肿瘤共33例(36.3%),发病前3位的是腺样囊性癌15例(16.5%)、腺癌6例(6.6%)、淋巴瘤5例(5.5%)。最常见的就诊原因是眼球突出,共50例(54.9%),其中30例为多形性腺瘤患者;其次是发现眉弓部包块,共22例(24.2%);第3位是眼及眼周围部疼痛,共9例(9.9%),其中5例为腺样囊性癌患者。结论云南地区泪腺区占位性病变手术患者中最常见的良性病变是多形性腺瘤,以眼球突出为主要症状;最常见的恶性病变是腺样囊性癌,以眼及眼周围部疼痛为主要症状。Objective To analyze the pathogenesis,histopathological classification and clinical features of lacrimal gland occupying lesions.Methods This was a retrospective case series study.Clinical data of 91 patients(102 eyes)with lacrimal gland area occupying diseases who received ophthalmic surgery in the Second People′s Hospital of Yunnan Province from January 2014 to November 2018 were retrospectively analyzed,including patients′age,reasons for treatment,gender,imageological examination data and pathological diagnosis results.All patients had more than one medical imaging examination results and histopathological diagnosis results.Results Among 91 cases,46 patients(50.5%)were male and 45(49.5%)were female.The age distribution ranged from 1.1 years to 72 years old,with an average age of 43 years.All of benign tumors added up to 58 cases(63.7%).Pleomorphic adenoma(43 cases,47.3%),dermoid cyst(6 cases,6.6%),and inflammatory pseudotumor(6 cases,6.6%)were the most common cases in the benign lacrimal gland occupying tumors.There were 33 cases(36.3%)of malignant tumors.Adenoid cystic carcinoma(15 cases,16.5%),adenocarcinoma(6 cases,6.6%)and lymphoma(5 cases,5.5%)had the highest incidence among the malignant lacrimal gland occupying tumors.The most common reason for seeking medical treatment was exophthalmos(50 cases,54.9%;30 cases were pleomorphic adenoma).Brow arch mass(22 cases,24.2%)and pain in and around the eye(9 cases,9.9%;5 cases were adenoid cystic carcinoma)were also major reasons.Conclusions The most common benign lacrimal gland area occupying lesion in surgery patients of Yunnan is pleomorphic adenoma,which more occurred in patients with exophthalmos as the main symptoms.The most common malignant tumor in the lacrimal gland area is adenoid cystic carcinoma and the most common reason to seek medical advice was pain in and around the eye.

关 键 词：泪器 眼肿瘤 腺瘤 多形性 皮样囊肿 癌 腺样囊性 肉芽肿 浆细胞 

分 类 号：R73[医药卫生—肿瘤]