38例眼附属器淋巴瘤的临床分析  

Clinical analysis of 38 cases of ocular adnexal lymphoma

作　　者：孙梅 葛心 柳睿 马建民 Sun Mei;Ge Xin;Liu Rui;Ma Jianmin(Department of Beijing Tongren Hospital Affiliated to Capital Medical University,Beijing Tongren Eye Center,Beijing Institute of Ophthalmology,Beijing Ophthalmology & Vision Science Key Lab,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院,北京同仁眼科中心,北京市眼科研究所,北京市眼科学与视觉科学重点实验室,100730

出　　处：《临床眼科杂志》2021年第5期451-456,共6页Journal of Clinical Ophthalmology

基　　金：北京市自然科学基金(7182038);北京市“登峰”人才培养计划(DFL20190201)。

摘　　要：目的探讨眼附属器淋巴瘤(OLAs)发病的一般情况、临床表现及病理特点。方法回顾性系列病例研究。选取2018年1月到2019年12月间,收治于首都医科大学附属北京同仁医院眼肿瘤科经手术病理证实为OALs患者38例,收集患者的临床资料进行分析。结果本研究纳入OALs患者38例(50只眼),其中男性24例(63.2%);发病年龄31~89岁,以60~70岁为主(13/38);病程平均(17.9±22.1)个月,其中高级别淋巴瘤的病程相对较短;单眼发病多见(26/38),发病部位以眼眶最多(21/38),其次是结膜(9/38)、眼睑(8/38);前3位最常见的体征分别为眼睑肿胀、眶周肿块和结膜肿物;该病以局限于眼附属器的原发性病变多见(34/38),CT及MRI检查可以显示病灶累及部位和范围。38例患者均经病理及免疫组化染色检查,结果显示MALT淋巴瘤31例,弥漫性大B细胞淋巴瘤3例,套细胞淋巴瘤2例,小淋巴细胞淋巴瘤和自然杀伤性T细胞淋巴瘤各1例。所有患者均接受手术治疗,手术后15例患者行密切观察,11例患者接受局部放射治疗,9例接受化学治疗,1例患者先后接受放射治疗和化学治疗,1例患者接受化学治疗联合免疫抑制剂治疗,1例失访;在随访过程中,3例复发,1例进展,其余患者病情稳定。结论OALs临床表现多样、病理分型复杂、影像学检查具有一定的特异性,其诊断金标准是病理学及免疫组化染色,该病的治疗方案多样,手术是诊断和治疗OALs的基础,术后根据具体病情需要进一步行放射治疗和/或化学治疗,综合治疗是减少疾病复发和进展的有效策略。Objective To investigate the incidence,clinical manifestations and pathological features of ocular adnexal lymphomas(OLAs).Methods The clinical data of 38 patients with OLAs confirmed by histopathologic examination in Beijing Tongren Hospital Affiliated to Capital Medical University from January 2018 to December 2019 were retrospectively analyzed.Results This study included 38 patients with OLAs,including 24 males(63.2%),and the age of onset was 31-89 years old,mainly 60-70 years old(13/38).The average disease course was 17.9±22.1 months,among which the course of high-grade lymphoma was relatively short.The most common location was orbit(21/38),followed by conjunctiva(9/38)and eyelid(8/38).The top three most common signs and symptoms were eyelid swelling,orbital mass and conjunctival mass.OALs was mostly a primary disease confined to the ocular adnexal(34/38).CT and MRI could display the location and extent of lesions.Pathological and immunohistochemical staining of the 38 patients revealed 31 MALT lymphomas,3 diffuse large B-cell lymphomas,2 mantle cell lymphomas,1 small lymphocytic lymphoma and 1 natural-killer T-cell lymphoma.All patients received surgical treatment,15 patients were closely observed after the surgery,among whom 11 patients received local radiotherapy,9 received chemotherapy,1 received radiotherapy and chemotherapy successively,1 received chemotherapy combined with immunosuppressive therapy and 1 was lost to follow-up.During the follow-up,3 patients relapsed,1 patient progressed,and the remaining patients were in stable condition.Conclusions The clinical manifestations of OALs varied,and complex pathological classification and specific imaging examination were also observed.The gold standard for diagnosing OALs is pathological examination combined with immunohistochemical staining.There are many treatment opitons for OALs,and surgery is the basis for diagnosis and treatment of OALs.Postoperative radiotherapy and/or chemotherapy are required according to specific condition.Comprehensive treatme

关 键 词：眼附属器 淋巴瘤 症状 病理 免疫组化 

分 类 号：R73[医药卫生—肿瘤]