1492例眼眶占位性病变临床病理学分析

Clinical and pathological analysis of 1492 cases with space-occupying orbital lesions

目的探讨北京同仁医院眼科中心眼眶占位性病变的疾病谱系和发病情况。设计回顾性病例系列。研究对象自1997年1月至2006年12月间北京同仁医院眼科中心病理室存档的1492例眼眶占位性病变。方法分析1492例眼眶占位性病变的临床病理资料,基本情况包括患者的年龄、性别及肿物的病理诊断。主要指标眼眶占位性病变的疾病谱系和发病情况。结果眼眶占位性病变依据组织来源主要分为15大类:囊肿性病变、脉管性病变、周围神经病变、视神经和脑膜病变、纤维组织病变、骨和软骨病变、脂肪组织病变、肌组织病变、泪腺病变、炎性病变、色素性病变、转移性肿瘤、淋巴增生性病变、继发性肿瘤、白血病和组织细胞系统病变、其它病变。其中良性病变1318例(88.3%),恶性病变174例(11.7%)。位于良性病变前5位的分别是皮样囊肿及表皮样囊肿、海绵状血管瘤、淋巴管瘤、泪腺混合瘤、慢性炎症和炎性假瘤;位于恶性肿瘤前5位的分别是淋巴瘤、泪腺囊腺癌、横纹肌肉瘤、黑色素瘤、皮脂腺腺癌。结论眼眶占位性病变涉及不同组织来源的病变。横纹肌肉瘤是儿童最常见的眶内恶性肿瘤,淋巴瘤是老年人最常见的眶内恶性肿瘤。(眼科,2007,16:398-402)

Objective To determine the spectrum and incidence of space-occupying orbital lesions performed at Beijing Tongren Eye Center. Design Retrospective case series. Participants A total of 1492 consecutive biopsies of space-occupying orbital lesions performed at Beijing Tongren Eye Center during January 1997 to December 2006. Methods A retrospective chart review was carried out for 1492 space-occupying orbital lesions over a 10-year period. The lesions were grouped into general categories, the age and gender of main lesions were determined respectively. Main Outcome Measures The spectrum and incidence of space-occupying orbital lesions. Results 1492 space-occupying orbital lesions were grouped into 15 general categories lesions as follows： cystic lesions, vasculogenic lesions, peripheral nerve lesions, optic nerve and meningeal tumors, fibrocytic lesions, osseous and cartilaginous tumors, lipocytic and myxoid lesions, myogenic tumors, lacrimal gland lesions, inflammatory lesions, primary melanocytic lesions, metastatic tumors, lymphoid lesions, secondary orbital tumors, leukemia and histiocytic lesions and miscellaneous other lesions. Among these lesions, 1318 （88.3%） were benign and 174 （11.7%） were malignant. The five most common benign lesions were dermoid cyst and epidermoid cyst, cavernous hemangioma, lymphangioma, pleomorphic adenoma, orbital inflammation. The five most common malignant lesions were lymphoma, lacrimal adenoid cystic carcinoma, rhabdomyosarcoma, melanoma, sebaceous gland carcinoma. Conclusions A variety of tumors and pseudotumors can involve the orbit. Lymphoma is the most common malignancy in old patients, and rhabdomyosarcoma is the most common malignancy in children. （Ophtholmol CHN, 2007, 16： 398-402）