眼眶黏膜相关淋巴组织结外边缘区B细胞淋巴瘤:24例的临床病理分析  

Orbital Extranodal Marginal Zone Lymphoma of Mucosa-Associated Lymphoid Tissue:A Clinicopathologic Study of 24 Cases

作　　者：章琼莹 秦晓怡 闫文卿 孙文文[1] Qiongying Zhang;Xiaoyi Qin;Wenqing Yan;Wenwen Sun(Department of Pathology,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,China;National Clinical Research Center for Ocular Diseases,Eye Hospital,Wenzhou Medical University,Wenzhou 325027,China)

机构地区：[1]温州医科大学附属第一医院病理科,温州325000 [2]温州医科大学附属眼视光医院国家眼耳鼻喉疾病(眼部疾病)临床医学研究中心,温州325027

出　　处：《中华眼视光学与视觉科学杂志》2025年第1期23-27,共5页Chinese Journal Of Optometry Ophthalmology And Visual Science

摘　　要：目的:探讨原发于眼眶的黏膜相关淋巴组织结外边缘区B细胞淋巴瘤(MALT淋巴瘤)的临床病理特征、鉴别诊断、发病机制及相关治疗,加深对该疾病的认识。方法:回顾性分析。收集2021—2024年间温州医科大学附属第一医院及温州医科大学附属眼视光医院24例眼眶MALT淋巴瘤的临床信息、病理及免疫组织化学结果,并进行相关文献复习。结果:24例原发于眼眶的MALT淋巴瘤,其中仅1例为复发,男女比例为2∶1,中位发病年龄58岁,14例位于左眼,10例位于右眼,均为单侧。有多种临床特征,除肉眼肿块外,7例伴随眼球突出,2例伴随眼红,2例伴随溢泪,1例伴随眼皮水肿。大体均表现为界限不清的鱼肉样肿块。病理诊断均为眼眶MALT淋巴瘤,其中19例为弥漫性生长模式,5例为结节性生长模式,镜下均表现为以单核样瘤细胞为主,其中2例可见浆细胞样分化,免疫表型均表达全B抗原,低表达Ki-67(阳性指数5%~15%)。结论:眼眶MALT淋巴瘤是眼眶最常见的惰性淋巴瘤类型,主要见于中老年人,诊断主要依靠影像学、病理学及免疫组织化学相结合。Objective:To explore the clinicopathological characteristics,differential diagnoses,pathogenesis,and treatment strategies of orbital extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue(MALT lymphoma)to enhance understanding and provide clinical reference.Methods:We retrospectively analyzed the clinical data,pathological features,and immunohistochemistry findings of patients diagnosed with orbital extranodal marginal zone MALT lymphoma between 2021-2024,and reviewed the related literature.Results:A total of 24 cases were analyzed,with only one case of relapse.The male-to-female ratio was 2:1,with the median age was 58 years.Among the cases,14 were located in the left orbit and 10 in the right orbit,all being unilateral.Various clinical features were observed,with all cases presenting a palpable mass.Additional symptoms included exophthalmos in 7 cases,erythema in 2 cases,epiphora in 2 cases,and eyelid edema in 1 case.Pathologically,the tumors were soft with poorly defined boundaries,and all were diagnosed as orbital MALT lymphoma.19 cases had diffuse growth pattern and 5 cases had a nodular growth pattern.The neoplastic cells exhibited abundant clear cytoplasm with a monocytoid appearance,with 2 cases showing plasmacytoid differentiation.All cases expressed B cell antigens and demonstrated a low Ki67 level(5%-15%).Conclusion:Orbital MALT lymphoma was the most common indolent lymphoma affecting the orbit,mainly observed in elderly individuals.Diagnosis primarily relied on a combination of imaging,pathology and immunohistochemistry.

关 键 词：病理学 眼眶黏膜相关淋巴组织结外边缘区B细胞淋巴瘤 临床病理特征 文献复习 

分 类 号：R739.72[医药卫生—肿瘤]