CAJ | 학술논문

目的探讨良性淋巴上皮病变的临床特点与治疗策略.方法回顾性系列病例研究.天津市眼科医院自2006年1月至2007年12月收治良性淋巴上皮病变9例,对患者的一般临床特性、影像学特征、组织病理学特点及治疗效果进行分析.结果 9例良性淋巴上皮病变患者中以女性、双眼发病者居多,表现为泪腺区无痛性肿大,口干,伴有不同程度的唾液腺肿大或唾液腺肿块切除病史.CT检查均表现为泪腺区边界清楚的均一性密度增高影.超卢检查显示泪腺区边界清楚、内回声均匀的椭圆形占位.6例患者接受糖皮质激素冲击治疗1或2个疗程,症状体征明显减轻.3例患者因应用药物治疗效果不明显,为进一步明确诊断行泪腺区肿物手术切除,术后病理诊断良性淋巴上皮病变,治疗后随访无复发.结论多数患者对糖皮质激素治疗敏感,首次治疗时可行糖皮质激素冲击.对于药物治疗欠敏感或临床诊断困难者可行手术切除,经组织病理学检查进一步明确诊断.
목적 탐토량성림파상피병변적림상특점여치료책략.방법 회고성계렬병례연구.천진시안과의원자2006년1월지2007년12월수치량성림파상피병변9례,대환자적일반림상특성、영상학특정、조직병이학특점급치료효과진행분석.결과 9례량성림파상피병변환자중이녀성、쌍안발병자거다,표현위루선구무통성종대,구간,반유불동정도적타액선종대혹타액선종괴절제병사.CT검사균표현위루선구변계청초적균일성밀도증고영.초로검사현시루선구변계청초、내회성균균적타원형점위.6례환자접수당피질격소충격치료1혹2개료정,증상체정명현감경.3례환자인응용약물치료효과불명현,위진일보명학진단행루선구종물수술절제,술후병리진단량성림파상피병변,치료후수방무복발.결론 다수환자대당피질격소치료민감,수차치료시가행당피질격소충격.대우약물치료흠민감혹림상진단곤난자가행수술절제,경조직병이학검사진일보명학진단.
Objective To report the clinical features of benign lymphcepithelial lesion and to further characterize recommendations for its therapy strategy. Methods It was a retrospective case sires. Retrospective analyze the clinical characteristics, imaging features, pathological manifestation and the treatment effect from the clinical materials of 9 cases of patients with benign lymphoepithelial lesion presenting to Tianjin Eye Hospital from Jan 2006 to Dec 2007. Results The 9 cases, in which 7 cases were female, 7 cases had lesions on beth eyes, demonstrated unpainful swelling of the lacrimal glands and in different degree of salivary glands or had history of tumor resection of salivary glands. Orbital CT scanning showed increased homogeneous density with clear boundary in the lacrimal gland area. Color doppler ultrasonography displayed elliptical space occupying with clear boundary and homogeneous internal eehos of the lacrimal gland area. Six patients received treatment with large dose of glucocorticoid for 1-2 courses, and the symptoms and signs were significantly alleviated. Three patients were operated to excise the lacrimal gland masses due to imperfect treatment effect of medication or in order to make definite diagnosis. The postoperative pathological results supported the diagnosis of benign lymphcepithelial lesion. No recurrence happened in the follow-up. Conclusions A clinical condition with swelling of either or both lacrimal gland and of any salivary gland, and accompanied with systemic relative diseases should be considered benign lymphoepithelial lesion. Imaging examinations are helpful to definite diagnosis. Most patients are sensitive to the glucocorticoid treatment. The dose of glucocorticoid should be large at the beginning of treatment. Surgical excision can be apphed to the cases insensitive to medications or difficult to be diagnosed. The definite diagnosis should be made through pathological examinations.