原发性泪道肿物64例临床组织病理学分析  

Clinical and pathological analysis of 64 patients with primary neoplasms of the lacrimal drainage system

作　　者：赵云[1] 惠靖雯 杨丽红 赵红[1] 林锦镛[1] 潘叶[1] Zhao Yun;Hui Jingwen;Yang Lihong;Zhao Hong;Lin Jinyong;Pan Ye(Tianjin Eye Hospital,Tianjin Key Lib.of Ophthalmology and Visual Science,Nankai University Affiliated Eye Hospital,Clinical College of Ophthalmology of Tianjin Medical University,Tianjin Eye Institute,Tianjin 300020,China)

机构地区：[1]天津市眼科医院,天津市眼科学与视觉科学重点实验室,南开大学附属眼科医院,天津医科大学眼科临床学院天津市眼科研究所,300020

出　　处：《中华眼科杂志》2020年第5期364-369,共6页Chinese Journal of Ophthalmology

基　　金：天津市眼科医院科技基金(YKYB1914)。

摘　　要：目的研究原发性泪道肿物的组织病理学分类和年龄分布情况。方法回顾性系列病例研究。选取2006年1月至2016年12月在天津市眼科医院经手术治疗后组织病理学检查确诊的64例(65只眼)原发性泪道肿物患者的临床和组织病理学资料。分析患者的性别、眼别、发病年龄、临床表现和良、恶性病变的构成情况。根据发病部位不同,分别统计原发性泪点肿物、泪小管肿物和泪囊肿物的组织病理学构成和年龄分布情况,并对患者的预后情况进行分析。结果64例原发性泪道肿物患者中男性23例(24只眼),女性41例(41只眼)。右眼36例,左眼27例,双眼1例。患者年龄(46±4)岁(12~78岁)。病程(13.1±4.2)个月。64例患者中,主诉为溢泪者43例,发现肿物者19例,溢脓者2例;伴有内眦角移位者29例,胀痛者21例。64例原发性泪道肿物患者中良性病变51例,交界性病变4例,恶性病变9例。按照发生部位分类,原发性泪点肿物17例,原发性泪小管肿物2例,原发性泪囊肿物45例。原发性泪点肿物均为良性病变,其中色素痣占首位(10例)。原发性泪小管肿物包括表皮样囊肿和变性物质各1例,均为良性病变。原发性泪囊良性病变(32例)中发生率前3位的为黏膜上皮囊肿(9例)、皮样囊肿(6例)和表皮样囊肿(6例);原发性泪囊交界性病变4例,包括软组织巨细胞瘤2例,孤立性纤维性肿瘤和炎性肌纤维母细胞瘤各1例;原发性泪囊恶性病变(9例)以鳞状细胞癌居首位(3例)。原发性泪点肿物患者中年龄40~59岁者多见(14例);原发性泪囊良性肿物患者中年龄<40岁(15例)和40~59岁(11例)者多见,而原发性泪囊交界性和恶性病变均为40岁以上患者。共49例患者完成随访,随访时间为(57.2±3.8)个月。1例泪囊移行细胞癌和1例泪囊黑色素瘤分别于泪囊肿物切除术后7个月和1年出现复发,经再次泪囊肿物切除术后分别随访24个月和38个月未复发。其余肿物�Objective To analyze the pathological classification and age distribution of primary neoplasms of the lacrimal drainage system.Methods Retrospective case series study. A total of 64 patients (65 eyes) were diagnosed with primary neoplasms of the lacrimal drainage system and received surgery at Tianjin Eye Hospital from January 2006 to December 2016. All the clinical data of the patients were analyzed, including gender, diseased eye, age, clinical manifestations, composition of benign and malignant masses, and prognosis. The histopathological composition and age distribution of patients with primary lacrimal mass, lacrimal duct mass and lacrimal sac mass were analyzed according to the different diseased sites.Results Twenty-three patients (24 eyes) were male, and 41 patients (41 eyes) were female. The right eye was involved in 36 patients, the left eye in 27 patients, and both eyes in one patient. The age at diagnosis ranged from 12 to 78 years old [mean, (46±4) years]. The course of disease was (13.1±4.2) months, ranging from 1 month to 7 years. The chief complaint was tear discharge in 43 patients, tumor in 19 patients, and abscess discharge in 2 patients. There were 29 patients with angular displacement and 21 patients with swelling pain. There were 51 patients with benign lesions, 4 with borderline lesions, and 9 with malignantlesions. These neoplasms consisted of primary peripunctal neoplasms in 17 patients, primary canalicular neoplasms in 2 patients, and primary lacrimal sac neoplasms in 45 patients. All primary peripunctal neoplasms (17 cases) were benign, among which nevi (10 cases) occupied the first place. All primary canalicular neoplasms (2 cases) were benign, there were 1 case of epidermoid cysts and 1 case of degenerative disease. Among the primary benign lacrimal sac masses (32 cases), mucous epithelial cysts (9 cases), dermoid cysts (6 cases), and epidermoid cysts (6 cases) occupied the first three places. Among the primary borderlin lacrimal sac masses (4 cases), there were 2 cases of giant cel

关 键 词：泪器疾病 眼肿瘤 痣 色素 表皮囊肿 皮样囊肿 癌 鳞状细胞 

分 类 号：R77[医药卫生—眼科] R73[医药卫生—临床医学]