原发性眼附属器MALT淋巴瘤的临床分析

Clinical analysis of ocular adnexal mucosa-associated lymphoid tissue lymphoma

目的 探讨原发性眼附属器MALT淋巴瘤的临床、病理特点及影像学表现.方法 回顾性分析近3年经病理证实为原发性眼眶MALT淋巴瘤患者的临床资料、病理学特点及影像学检查情况.结果 38例原发性眼附属器MALT淋巴瘤,26例发生于眼眶,占68％,6例发生于泪腺区,占15.8％,少数发生于结膜;单侧多发,也可双眼同时发病.临床表现为跟睑肿胀、眼球突出、结膜充血及鱼肉样外观、复视及视力下降等.其具有独特的病理学特征：免疫组织化学染色示CD20（＋）,CD79a（＋）.CT对眶骨结构及肿瘤侵犯范围与周围组织的关系,具有定性诊断价值;MRI对软组织的分辨率强,可以准确判断病变累及的范围及与邻近组织的情况.结论 发生于眼眶的MALT淋巴瘤,病理及影像学检查具有一定的特征性,结合患者的临床特征及影像学检查综合分析,可提高术前诊断率.

Objective To study the clinical histopathological character and imaging feature of ocular adnexal mucosa-associated lymphoid tissue（MALT） lymphoma.Methods A retrospective study of MALT lymphoma was performed to investigate the histopathological feature,clinical and imaging data.Results The most common kind of MALT lymphoma was orbit 68% （26/38）,minority was lacrimal gland 15.8% （6/38）.It could also occur in the conjunctiva,most single eye,but could also occur on both eyes.The main clinical manifestations of MALT lymphoma were eyelid swelling,ocular proptosis,conjunctival hyperemia,diplopia and vision depression,the unique pathological features：immunohistochemical staining showed CD20 （＋）,CD79a （＋）.CT could discover the structure orbit and the relation between infiltrative region and ambient tissue,had the qualitative region to diagnosis;MRI had strong discrimination of the soft tissue,imaging parameter based on different signal intensity to accurately determine the extent of the lesion of the lymphoma.Conclusions MALT lymphoma is commonly localized in lacrimal gland and conjunctive region.Ocular adnexal lymphoma show characteristic pathology and imaging manifestations,so it is important for primary diagnosis with combination of clinical and imaging appearances to improve the preoperative diagnostic rate.