泪腺占位性病变的临床病理学分析

Clinical and pathological analysis of 151 cases of tumors in lacrimal fossa

目的研究泪腺占位性病变的临床特征和组织病理学类型。方法收集1996至2003年在我院经组织病理学确诊的泪腺占位性病变151例患者的病史资料和组织标本切片,对其临床表现、组织来源、组织病理学特征及预后情况进行回顾性总结和分析。结果在151例泪腺占位性病变患者中,上皮来源肿瘤103例(68.2%),其中良性者69例,分别为多形性腺瘤63例(41.7%),肌上皮瘤3例(2.0%),泪腺导管囊肿2例(1.3%),基底细胞腺瘤1例(0.7%);恶性者34例,分别为腺样囊性癌15例(9.9%),恶性多形性腺瘤14例(9.3%),腺癌4例(2.6%),转移性类癌1例(0.7%)。泪腺非上皮性病变48例(31.7%),最常见者分别为黏膜相关淋巴样组织(MALT)淋巴瘤17例(11.3%),炎性假瘤12例(7.9%),良性淋巴上皮病7例(4.6%)。结论泪腺占位性病变种类多样,其中泪腺多形性腺瘤的治疗和MALT淋巴瘤的诊断是目前临床亟待解决的问题。

Objective To investigate the clinical features and pathological classification of tumors in lacrimal fossa. Methods A retrospective study of 151 cases of tumors in lacrimal fossa in recent 8 years from EENT hospital was performed to investigated the clinical features, histopathological classification and prognoses. Results In 69 cases of benign lacrimal epithelial tumors, pleomorphic adenoma was the most common tumor （ 63 cases, 41.7% ）, followed by myoepithelioma （ 3 cases, 1.2% ）, lacrimal duct cyst （2 cases, 1.3% ）. In 34 cases of malignant lacrimal epithelial tumors, adenoid cystic carcinoma was the most common tumor （15 cases, 9.9% ）, followed by pleomorphic adenocarcinoma （14 cases, 9. 3% ）, adenocarcinoma （4 cases, 2. 6% ）. There were 48 cases of lacrimal non-epithelail lesions. Mucosaassociated lymphoid tissue （MALT） lymphoma was the most common tumor （ 17 cases, 11.3% ）, followed by pseudotumor （ 12 cases, 7. 9%）, benign lymphoepithelial lesion （ 7 cases, 4. 0%）. Conclusions There are a variety of tumors in lacrimal fossa. The treatment of pleomorphic adenoma and the diagnosis of MALT lymphoma are the most difficuhe tasks in present clinical work. （Chin J Ophtbalmol, 2005,41：877-881 ）