CAJ | 학술논문

目的探讨泪腺腺样囊性癌的放射学特征及临床病理学特点.方法回顾性系列病例研究.2009年9月至2011年11月天津第一中心医院眼科共收治12例泪腺腺样囊性癌患者,所有诊断均经病理检查证实.男性5例,女性7例,年龄22 ～ 63岁,平均年龄42.6岁.12例患者均行眼眶CT检查,10例行MRI检查.采用电话及门诊复查方式对患者进行随访,其中2例患者失访.结果 12例肿瘤均发生在泪腺眶部.临床表现为疼痛10例,眼球突出9例,上睑下垂4例,视力下降3例,复视2例.依据第7版美国癌症联合委员会对泪腺区肿瘤TNM分级:T1N0M0 1例,T2N0M0 4例,T4N0M0 7例.术前CT检查发现有眶壁骨质改变的7例患者中,病理学检查结果证实6例有眶壁骨质改变；术前CT检查未发现有眶壁骨质改变的5例患者中,病理学检查结果证实1例有眶壁骨质累及.CT检查对骨质累及检查的阳性率为6/7.术前MRI检查发现有眶壁骨质改变的7例中,6例经病理检查结果证实有眶壁骨质改变；术前MRI检查未发现眶壁骨质改变的3例均经病理检查结果证实无眶壁骨质改变.MRI对骨质累及检查的阳性率为6/7.7例病理检查结果证实有眶壁骨质改变的患者中,实体型5例、混合型2例.术后复发3例.结论泪腺腺样囊性癌的CT和MRI检查结果有一定的特征性.泪腺腺样囊性癌常伴有眶壁骨质的受累,实体型肿瘤组织本身的侵袭性较强.局部肿瘤的复发与肿瘤的病理学类型及分期(眶壁骨质是否受累)有一定关联.
목적 탐토루선선양낭성암적방사학특정급림상병이학특점.방법 회고성계렬병례연구.2009년9월지2011년11월천진제일중심의원안과공수치12례루선선양낭성암환자,소유진단균경병리검사증실.남성5례,녀성7례,년령22 ～ 63세,평균년령42.6세.12례환자균행안광CT검사,10례행MRI검사.채용전화급문진복사방식대환자진행수방,기중2례환자실방.결과 12례종류균발생재루선광부.림상표현위동통10례,안구돌출9례,상검하수4례,시력하강3례,복시2례.의거제7판미국암증연합위원회대루선구종류TNM분급:T1N0M0 1례,T2N0M0 4례,T4N0M0 7례.술전CT검사발현유광벽골질개변적7례환자중,병이학검사결과증실6례유광벽골질개변；술전CT검사미발현유광벽골질개변적5례환자중,병이학검사결과증실1례유광벽골질루급.CT검사대골질루급검사적양성솔위6/7.술전MRI검사발현유광벽골질개변적7례중,6례경병리검사결과증실유광벽골질개변；술전MRI검사미발현광벽골질개변적3례균경병리검사결과증실무광벽골질개변.MRI대골질루급검사적양성솔위6/7.7례병리검사결과증실유광벽골질개변적환자중,실체형5례、혼합형2례.술후복발3례.결론 루선선양낭성암적CT화MRI검사결과유일정적특정성.루선선양낭성암상반유광벽골질적수루,실체형종류조직본신적침습성교강.국부종류적복발여종류적병이학류형급분기(광벽골질시부수루)유일정관련.
Objective To study the imaging and histologic features of adenoid cystic carcinoma (ACC) of the lacrimal gland.Methods It was a restrospective case series study.Twelve patients with ACC of the lacrimal gland were surgically treated in Tianjin First Center Hospital from September 2009 to November 201 1.The 5 men and 7 women aged from 22 to 63 years(average 42.6 years).The imaging and histologic features of 12 cases with ACC of the lacrimal gland pathologically confirmed were retrospectively reviewed.Twelve cases were performed with CT scan,10 cases with MRI scan.All patients were followed up by telephone and reexamination in the outpatient service,and 2 patients were lost to follow-up.Results The lesions originated in the orbital lobe of the lacrimal gland.The most commom presenting symptom was pain;it was followed by proptosis,ptosis,decreased visual acuity and diplopia.The 7th Edition of the American Joint Committee on Cancer TNM Classification system for Lacrimal Gland Tumors stages were as follows:T1N0M0 1 patients,T2N0M0 4 patients,T4N0M0 7 patients.Preoperative CT imaging suggested that bony involvement of the lacrimal gland fossa in 7 patients; this was histologically confirmed in 6 of the 7.Preoperative CT imaging suggested no bone involvement in 5 patients,1 of whom had bone involvement by histology.The positive rate of CT scan was 6/7.Preoperative MRI imaging suggested that bony involvement of the lacrimal gland fossa in 7 patients; this was histologically confirmed in 6 of the 7.Preoperative MRI imaging suggested no bone involvement in 3 patients who were confirmed by histology.The positive rate of MRI scan was 6/7.Overall,7 of 12 histologically evaluable cases had bone invasion.Five of the histologically proven 7 patients with bone involvement had a predominantly basaloid pattern,2 mixed pattern.Three patients had local recurrence.Conclusions The imaging for ACC of the lacrimal gland is characteristic.ACC of the lacrimal gland is associated with the high rate of bone invasion.The basaloid variety has more aggressive biologic behavior.The risk of local recurrence may be associated with the histologic types and stages of lacrimal gland adenoid cystic carcinoma.