泪腺窝占位病变病理分类及临床特征分析

Analysis of the pathological classification and clinical features of occupying lesions in lacrimal fossa

目的 研究泪腺窝肿瘤及肿瘤样病变的病理类型和临床特征.方法 收集2001年1月至201 1年5月在邢台市眼科医院就诊的经病理证实的泪腺部占位病变339例患者的临床资料,对其组织来源、临床及影像特征等进行回顾性分析.结果 339例中,泪腺上皮性肿瘤135例（135/339,39.82％）,泪腺非上皮性肿瘤204例（204/339,60.18％）.在泪腺上皮性肿瘤中,良性上皮性肿瘤76例（76/135,56.30％）,恶性上皮性肿瘤59例（59/135,43.70％）.单侧眼眶275例（275/339,81.12％）,双侧眼眶64例（64/339,18.88％）.来源于表皮外胚层144例（144/339,42.48％）,中胚层152例（152/339,44.84％）,骨髓造血系统30例（30/339,8.85％）,其它13例（13/339,3.83％）.结论 泪腺窝占位病变种类繁多、组织来源多样,以泪腺上皮性肿瘤和泪腺炎性假瘤最多见,双侧发病者以泪腺非上皮性病变多见,不同病理类型的肿瘤和病变,其临床与影像特征有其共性和非共同性,据其不同的特点为鉴别诊断提供依据.

Objective To explore the pathological classification and clinical features of tumors and tumor-like lesions in lacrimal fossa.Methods All 339 cases of lacrimal occupying lesions confirmed by pathology were collected in Xingtai Eye hospital from Jan 2001 to May 2011.The histological origin,clinical features and imaging manifestation of the lesions were retrospectively analyzed.Results In 339 cases of lacrimal lesions,there were 135 （135/339,39.82%） cases of lacrimal ephithlial tumorsand 204 （204/339,60.18%） cases of lacrimal non-epithelial lesions.There were 76 （76/135,56.30%） cases of benign tumors and 59 （59/135,43.70%） cases of malignant tumors in lacrimal ephithlial tumors.There were 275 （275/339,81.12%） cases of lesions located in unilateral lacrimal fossa and 64 （64/339,18.88%） cases in bilateral lacrimal fossa.There were 144 （144/339,42.48%） cases derived from epidermal ectoderm,152 （152/339,44.84%） cases from mesoderm,30 （30/339,8.85%） cases from marrow hematopoietic system and 13 （13/339,3.83%） cases were unidentified.Conclusions There are various kinds and histological origin of occupying lesions in lacrimal fossa,majority of them are lacrimal epithelial tumors and lacrimal pseudotumors,most portion of bilateral lesions are lacrimal non-epithelial tumors.Lacrimal tumors have the same or specific clinical and image feature varies with its pathological types which provide evidence for differential diagnosis.