眼眶占位性病变610例的临床病理学分析

Clinicopathological analysis of 610 cases with orbital space-occupying lesions

目的探讨眼眶占位性病变的临床病理学构成情况。方法回顾性病例系列研究。收集郑州大学第一附属医院2021年1月至2023年9月行眼眶占位性病变切除术并明确组织病理学诊断为眼眶占位病变者610例的资料。按照不同组织发生学类型、病变性质及年龄分类,对其构成情况进行分析。结果本研究610例患者中,男性270例(44.26%),女性340例(55.74%)。按组织学来源分类:前5位依次为脉管性肿瘤170例(27.87%)、眼眶囊肿138例(22.62%)、泪腺肿瘤74例(12.13%)、淋巴造血系肿瘤62例(10.16%)、炎性病变47例(7.70%)。按病变性质分类:473例良性病变中,前5位依次为海绵状血管瘤133例(28.12%)、皮样囊肿82例(17.34%)、泪腺多形性腺瘤49例(10.36%)、炎性假瘤33例(6.98%)、血管畸形29例(6.13%);137例恶性病变中,前3位依次为非霍奇金淋巴瘤55例(40.15%)、继发性肿瘤32例(23.36%)、腺样囊性癌24例(17.52%)。本研究患者年龄范围1个月~89岁,其中115名儿童青少年患者(0~<18岁)最常见的良性病变为皮样囊肿42例(36.52%),恶性病变为横纹肌肉瘤5例(4.35%);349名中青年患者(18~<60岁)最常见的良性病变为海绵状血管瘤106例(30.37%),恶性病变为腺样囊性癌18例(5.16%);146名老年患者(≥60岁)最常见的良性病变为海绵状血管瘤25例(17.12%);恶性病变为非霍奇金淋巴瘤37例(25.34%)。结论眼眶占位性病变种类多样,良性病变以海绵状血管瘤常见,恶性病变以非霍奇金淋巴瘤常见。

Objective To investigate the histopathological classification of orbital space-occupying lesions.Methods This was a retrospective case series study.The clinical and pathological data of 610 patients with orbital space occupying lesions who underwent surgical resection and confirmed histopathological diagnosis from Jan.2021 to Sep.2023 in the First Affiliated Hospital of Zhengzhou University were collected.The pathological results were classified based on histogenesis,pathological nature and age,and their composition was analyzed.Results Among 610 cases of patients in this study,270 cases(44.26%)were male and 340 cases(55.74%)were female.Classification by histological origin:the top 5 were categorized as vascularized tumors in 170 cases(27.87%),orbital cysts in 138 cases(22.62%),lacrimal gland tumors in 74 cases(12.13%),lymphopoietic tumors in 62 cases(10.16%),and inflammatory lesions in 47 cases(7.70%).Classification by lesion nature:among the 473 benign lesions,the top 5 were cavernous hemangioma in 133 cases(28.12%),dermoid cysts in 82 cases(17.34%),lacrimal pleomorphic adenoma in 49 cases(10.36%),inflammatory pseudotumor in 33 cases(6.98%)and vascular malformation in 29 cases(6.13%).Among the 137 malignant lesions,the top 3 were non-Hodgkin lymphoma in 55 cases(40.15%),secondary tumor in 32 cases(23.36%)and adenoid cystic carcinoma in 24 cases(17.52%).The age of the patients ranged from 1 month to 89 years.The most common benign lesion in 115 children and adolescents(0-<18 years old)was dermoid cyst in 42 cases(36.52%)and malignant lesion was rhabdomyosarcoma in 5 cases(4.35%).The most common benign lesions in 349 young and middle-aged patients(18-<60 years old)were cavernous hemangioma in 106 cases(30.37%),and malignant lesions were adenoid cystic carcinoma in 18 cases(5.16%).The most common benign lesion in 146 elderly patients(≥60 years old)was cavernous hemangioma in 25 cases(17.12%).The malignant lesion was non-Hodgkin’s lymphoma in 37 cases(25.34%).Conclusion Orbital space occupying lesions involve varied types.Cavernous hemangioma is common benign lesion,and non-Hodgkin’s lymphoma is common malignant lesion.