CAJ | 학술논문

目的探讨17例眼附属器结节病临床特点和诊断治疗经验.方法回顾性系列病例研究.回顾分析1993年1月至2008年10月在复旦大学附属眼耳鼻喉科医院治疗并经病理证实的17例眼附属器结节病患者的临床资料.结果男性4例,女性13例;年龄15～70岁,平均46.9岁;病变位于眼眶8例,泪腺5例,眼睑4例.14例主诉局部肿块,2例主诉眼球突出,1例主诉眼睑肿胀.并发肺部结节病3例,葡萄膜炎3例,皮肤结节病1例.6例中有4例血管紧张索转化酶增高,其中2例高于正常七限2倍以上.11例眼眶CT表现为中等密度实质性占位影,1例表现为低密度囊性占位影.5例B超表现为内回声均匀的低回声占位,1例表现为内回声不均匀的低回声占位.所有患者均经手术治疗,7例患者辅以糖皮质激素口服治疗.14例患者随访1至15年,无复发或再生长,3例失访.结论眼附属器结节病临床报道较少,多发生于中年女性,常表现为局部肿块,CT多表现为中等密度实质性占位,B超多表现为内回声均匀的低回声占位,应作为眼附属器占位性病变的鉴别诊断之一.病灶局限者可手术切除,病变广泛或并发全身病变者需辅以糖皮质激素治疗,并密切随访.
목적 탐토17례안부속기결절병림상특점화진단치료경험.방법 회고성계렬병례연구.회고분석1993년1월지2008년10월재복단대학부속안이비후과의원치료병경병리증실적17례안부속기결절병환자적림상자료.결과 남성4례,녀성13례;년령15～70세,평균46.9세;병변위우안광8례,루선5례,안검4례.14례주소국부종괴,2례주소안구돌출,1례주소안검종창.병발폐부결절병3례,포도막염3례,피부결절병1례.6례중유4례혈관긴장색전화매증고,기중2례고우정상칠한2배이상.11례안광CT표현위중등밀도실질성점위영,1례표현위저밀도낭성점위영.5례B초표현위내회성균균적저회성점위,1례표현위내회성불균균적저회성점위.소유환자균경수술치료,7례환자보이당피질격소구복치료.14례환자수방1지15년,무복발혹재생장,3례실방.결론 안부속기결절병림상보도교소,다발생우중년녀성,상표현위국부종괴,CT다표현위중등밀도실질성점위,B초다표현위내회성균균적저회성점위,응작위안부속기점위성병변적감별진단지일.병조국한자가수술절제,병변엄범혹병발전신병변자수보이당피질격소치료,병밀절수방.
Objective To study the diagnosis and treatment of 17 patients with sarcoidosis in ocular adnexa.Methods The clinical data of 17 cases with sarcoidosis in ocular adnexa treated during 1993 and 2008 were retrospectively analyzed.All patients underwent surgical treatment, and the diagnosis was proven histopathologically.Results Among the 17 cases, 4 were male, and 13 were female.The patients' age ranged from 15 to 70 years, with a mean of 46.9 years.The lesions were located at the orbit (8 cases) , lacrimal grand (5 cases) and eyelids (4 cases).Fourteen cases complained of the presence of a local mass, 2 cases complained of exophthalmos and 1 swelling of eyelids.Concurrent systemic sarcoidosis was present in 7 cases.Three cases coincided with lung sarcoidosis, 3 cases with uveitis and 1 case with dermatopathy.Angiotensin converting enzyme analysis was performed in 6 cases; 4 of them were elevated.Computer tomography was performed in 12 cases; in 11 cases it presented as moderate density parenchymatous mass, and in the remaining one it presented as hypodensity cystic mass.B scan of 5 cases showed hypoechonic parenchymatous homogeneous mass.None of 14 cases relapsed after 1 to 15 years follow-up.Conclusions Ocular adnexal sarcoidosis usually presents as local mass and it should be included in the differential diagnosis of orbital and ocular adnexal lesions.Excision of localized mass alone could achieve satisfactory outcomes for isolated lesions, while for diffuse or systematic lesions, corticosteroid treatment should be prescribed routinely.