233例眼眶占位性病变的组织病理学分析

The pathological analysis of 233 patients with orbital space-occupying lesion

目的分析眼眶占位性病变的组织病理学分类。方法对河南省眼科研究所2001年1月～2007年9月眼科病理室存档的233例眼眶占位性病变手术切除标本进行组织病理学分类。结果良性病变191例(81.97%),其中前3位依次为海绵状血管瘤60例(25.75%),炎症22例(9.44%),皮样囊肿13例(5.58%)。恶性病变42例(18.03%),其中原发性恶性肿瘤20例(8.97%),包括淋巴瘤10例(4.29%),泪腺上皮性恶性肿瘤4例(1.72%),横纹肌肉瘤3例(1.29%),纤维肉瘤1例(0.43%),其他2例(0.86%);继发性恶性肿瘤22例(9.87%),分别为眼睑皮脂腺癌眼眶蔓延9例(3.86%),眼睑鳞状细胞癌眼眶蔓延6例(2.58%),眼睑黑色素瘤眼眶蔓延3例(1.29%),视网膜母细胞瘤眶内蔓延3例(1.29%),眼睑基底细胞癌眼眶蔓延1例(0.43%)。结论眼眶占位性病变中脉管源性肿瘤最常见,其中最多见的是海绵状血管瘤,恶性病变中最多见的是淋巴瘤。

Objective To locate and evaluate the orbital space-occupying lesions is helpful for accurate diagnosis and treatment of orbital tumor in clinic. This study was to analyze the pathological classification of orbital space-occupying lesions. Methods 233 eyes of 233 cases with orbital neoplasms from January 2001 to September 2007 in Henan Eye Institute were reviewed retrospectively,and pathological diagnosis of these orbital neoplasms were clinically analyzed. Results Benign neoplasm was found in 191 of 233 eyes （81.97%） ,including cavernous hemangioma in 60 eyes （25.75%）,infammatory lesion in 22 eyes （9. 44% ）,dermoid cyst in 13 eyes （5.58%） ,epidermoid cyst in 11 eyes （4.72%） and vascular hamatoma in 11 eyes （4. 72% ）. The malignant tumor was diagnosed in 42 of 233 eyes （ 18. 03% ） and 20 of them （8.97%） were primary malignant tumors,including lymphoma in 10 eyes （4.29%） ,malignant lacrimal gland epithelial tumors in 4 eyes （ 1.72% ）, rhabdomyosarcoma in 3 eyes （ 1.29% ）, fibrosarcoma in 1 eye （0. 43% ） , eosinophilic granuloma in 1 eye （0. 43% ） ,malignant vascular tumor in 1 eye （0. 43% ） and other tumors in 2 eyes （0. 86% ）. Twenty- two eyes （9.87%） presented secondary malignant tumor,including orbital extention of sebaceous gland carcinoma in 9 eyes （3. 86% ） , orbital extention of squamous cell carcinoma of eyelid in 6 eyes （2.58%） ,orbital extention of melanoma of eyelid in 3 eyes （ 1.29% ）, orbital extention of retinoblastoma in 3 eyes （ 1.29% ） and orbital extention of basal cell carcinoma of eyelid in 1 eye （0. 43% ）. Conclusion The vascular tumor is the leading one in orbital space-occupying lesions. Cavernous hemangioma is the most common tumor among vascular tumor,and lymphoma is the most malignant tumor in orbit.