CAJ | 학술논문

目的探讨原发性眼附属器淋巴瘤(POAL)的临床特点、治疗方法及疗效.方法回顾性分析1999年6月至2009年6月经病理证实的26例POAL的临床资料,对其临床表现、影像学特点、病理类型及治疗进行分析.结果临床特点多表现为缓慢生长的无痛性肿块、眼球突出和眼睑红肿;影像学检查多呈"铸造"状,50%发生在眼眶.病理分型:22例患者为B细胞来源淋巴瘤,其中13例为结外边缘区B细胞淋巴瘤-黏膜相关淋巴组织型(MALT)淋巴瘤,2例为NK/T细胞淋巴瘤.临床分期:Ⅰ～Ⅱ期占总数的76.9%.手术切除和放化疗为主要治疗手段.结论 POAL多为B细胞来源,MALT淋巴瘤最为常见,恶性度相对较低.临床表现无明显特征性,影像学检查有助于诊断,但难以区别良恶性质,易误诊漏诊.确诊依赖于组织病珲学检查.早期经手术切除后可行单独放疗,恶性度高、出现眶外侵犯者应联合化疗.免疫和分子靶向治疗为今后研究的方向.
목적 탐토원발성안부속기림파류(POAL)적림상특점、치료방법급료효.방법 회고성분석1999년6월지2009년6월경병리증실적26례POAL적림상자료,대기림상표현、영상학특점、병리류형급치료진행분석.결과 림상특점다표현위완만생장적무통성종괴、안구돌출화안검홍종;영상학검사다정"주조"상,50%발생재안광.병리분형:22례환자위B세포래원림파류,기중13례위결외변연구B세포림파류-점막상관림파조직형(MALT)림파류,2례위NK/T세포림파류.림상분기:Ⅰ～Ⅱ기점총수적76.9%.수술절제화방화료위주요치료수단.결론 POAL다위B세포래원,MALT림파류최위상견,악성도상대교저.림상표현무명현특정성,영상학검사유조우진단,단난이구별량악성질,역오진루진.학진의뢰우조직병혼학검사.조기경수술절제후가행단독방료,악성도고、출현광외침범자응연합화료.면역화분자파향치료위금후연구적방향.
Objective To study the clinical characteristics and analyze the treatment of primary ocular adnexal lymphoma (POAL). Methods A retrospective review was performed based on the clinical records of 26 POAL cases, who were treated from June 1999 to June 2009. The clinical manifestations,imaging features, diagnosis approaches and treatment of them were analyzed. Results The main symptoms were a slowly growing painless mass, exophthalmia and red eyelid. Mostly, imaging finding shows "casting like". 50 % of POAL was at the orbit. 22 patients w ere B-cell origin [13 patients were extranodal marginal zone B-cell lymphoma-mucosal-associated lymphoid tissue (MALT) lymphoma], 2 patients were NK/T cell lymphoma. 76.9 % patients were in stage Ⅰ -Ⅱ. Surgery, radiotherapy and chemotherapy were most common treatment modalities for POAL. Conclusion Most POAL were low-grade B-cell lymphoma, with MALT by far the most common type. POAL was easy to be misdiagnosed due to non specific clinical manifestations.Imaging finding was helpful to diagnosis, but could not reliably distinguish between benign and malignant. The invasive biopsy is the main diagnosis approach. Radiotherapy had been the standard treatment for low-grade POAL. High-grade or infiltrating peri-orbit need combine chemotherapy. lmmunotherapy and molecular targeted therapy were the direction of future research.