安徽医学
安徽醫學
안휘의학
ANHUI MEDICAL JOURNAL
2009年
8期
855-858
,共4页
汪亮%杨华胜%张平%高际平
汪亮%楊華勝%張平%高際平
왕량%양화성%장평%고제평
良性淋巴上皮病变%上皮-肌上皮岛%眼眶
良性淋巴上皮病變%上皮-肌上皮島%眼眶
량성림파상피병변%상피-기상피도%안광
Benign lymphoepithelial lesion%Lacrimal secretion%Orbit
目的 探讨眼眶良性淋巴上皮病变的临床诊治和病理特点.方法 回顾性分析16例眼眶良性淋巴上皮病变临床和病理特点.结果 16例患者临床均表现为双侧泪腺弥漫、均匀、持续肿大,同时合并有不同程度的大涎腺肿大,病变局限于腺体,无眼外肌肥大;16例病理标本检查均未发现上皮-肌上皮岛结构,16例均有典型的淋巴细胞呈多克隆性增生浸润,病理检查排除淋巴组织增生性疾病;16例眼眶良性淋巴上皮病变患者均对糖皮质激素治疗敏感,治疗后经过2个月到9年的观察及随访,除1例患者自行停用糖皮质激素而复发外,其余患者均未复发.结论 眼眶良性淋巴上皮病变可能并不具有上皮-肌上皮岛结构.眼眶良性淋巴上皮病变的诊断主要基于以下几点:①临床表现为多发性腺体弥漫、均匀、持续肿大,即泪腺合并大的涎腺肿大;②无眼干及全身结缔组织疾病;③病理标本检查腺体均有典型的淋巴细胞多克隆性增生浸润,排除淋巴细胞增生性疾病及其他引起泪腺肿大的疾病;④对糖皮质激素治疗敏感.
目的 探討眼眶良性淋巴上皮病變的臨床診治和病理特點.方法 迴顧性分析16例眼眶良性淋巴上皮病變臨床和病理特點.結果 16例患者臨床均錶現為雙側淚腺瀰漫、均勻、持續腫大,同時閤併有不同程度的大涎腺腫大,病變跼限于腺體,無眼外肌肥大;16例病理標本檢查均未髮現上皮-肌上皮島結構,16例均有典型的淋巴細胞呈多剋隆性增生浸潤,病理檢查排除淋巴組織增生性疾病;16例眼眶良性淋巴上皮病變患者均對糖皮質激素治療敏感,治療後經過2箇月到9年的觀察及隨訪,除1例患者自行停用糖皮質激素而複髮外,其餘患者均未複髮.結論 眼眶良性淋巴上皮病變可能併不具有上皮-肌上皮島結構.眼眶良性淋巴上皮病變的診斷主要基于以下幾點:①臨床錶現為多髮性腺體瀰漫、均勻、持續腫大,即淚腺閤併大的涎腺腫大;②無眼榦及全身結締組織疾病;③病理標本檢查腺體均有典型的淋巴細胞多剋隆性增生浸潤,排除淋巴細胞增生性疾病及其他引起淚腺腫大的疾病;④對糖皮質激素治療敏感.
목적 탐토안광량성림파상피병변적림상진치화병리특점.방법 회고성분석16례안광량성림파상피병변림상화병리특점.결과 16례환자림상균표현위쌍측루선미만、균균、지속종대,동시합병유불동정도적대연선종대,병변국한우선체,무안외기비대;16례병리표본검사균미발현상피-기상피도결구,16례균유전형적림파세포정다극륭성증생침윤,병리검사배제림파조직증생성질병;16례안광량성림파상피병변환자균대당피질격소치료민감,치료후경과2개월도9년적관찰급수방,제1례환자자행정용당피질격소이복발외,기여환자균미복발.결론 안광량성림파상피병변가능병불구유상피-기상피도결구.안광량성림파상피병변적진단주요기우이하궤점:①림상표현위다발성선체미만、균균、지속종대,즉루선합병대적연선종대;②무안간급전신결체조직질병;③병리표본검사선체균유전형적림파세포다극륭성증생침윤,배제림파세포증생성질병급기타인기루선종대적질병;④대당피질격소치료민감.
Objective To assess the clinical diagnosis, therapy and pathology of benign lymphoepithelial lesion (BLEL) in the orbit. Methods A retrospective study was conducted to document 16 patients with bilateral lacrimal glands BLEL Since 2004 year, Schirmer's tests were performed on all 10 patients prior to and after surgery,and the paired Student's t-tost was used in this study. Results All 16 patients without extraoeular muscle enlargement have symmetrical and persistent swelling in more than two lachrymal and major salivary glands. Accom-partied with different degrees of plasma cells and eosinophilic granulocytes etc, prominent muhiclonal Lymphocyte infiltration was fund in all 16 cases' lachrymal glands, as a result of histopathologic xamination,lymphadenism was ruled out. All 16 patients respond well to steroid therapy. After 2 to 108 months' follow-up, all cases peformed with steroid therapy haven't recurred,except one case because the patient had stopped tak-ing prednisone without doctor's orders. At 1 month after treatment, non-surgical eyes have more reflex lacrimal secretion than that of surgical eyes and non-surgical eyes themselves before being treated (P<0.05), surgical eyes have no more lacrimal secretion than themselves without be-ing treated (P>0.05). Conclusion Benign lymphoepithelial lesion (BLEL) in the orbit is diagnosed mainly according to the following criteria: (1) symmetrical and persistent swelling in more than two lachrymal and major salivary glands; (2)Accompanied with different degrees of plasma cells and eosinophilic granulocytes erc,prominent multiclonal Lymphocyte infdtration exist in lachrymal and salivary glands,and other diseases that present with glandular swelling are ruled out; (3)Responding well to steroid therapy.At sugery, the lacrimal gland mass shoud not be com-pletely removed,for glucocorticoids is very effective to BLEL and these lacrimal glands still remain part of secreting function after therapy.
