泪腺良性淋巴上皮病变临床表现及诊断思路的研究

摘要

Objective To analyze the clinical features and diagnostic methods for benign lympboepithelial lesion (BLEL) of lacrimal gland. Methods 16 consecutive cases with benign h/mphoepithelial lesion confirmed by bistopatholog-ic examination were retrospectively reviewed, and the clinical features, imaging findings and laboratory tests was analyzed. Results In all 16 cases, me ratio of male to female was 1:7: age range was from 36 to 63 years old, in which most of them aged between 41 and SO:the ratio of unilateral eye to bilateral eyes was 1:7, painless uncongestive continuous swelling of the upper eyelid(s) was the main clinical manifestation. Orbital magnetic resonance imaging (MRI) showed that all cases involved both eyelid(s) and lacrimal gland that were enlarged obviously with equal signal in T,WI and T2WI with obvious enhancement on contrast MRI. Extraocular muscle was involved in 3 cases, temporalis was involved in 1 case and frontal nerve was involved in 1 case: there were no other abnormal foundings except one patient with positive hepatitis C antibody in laboratory tests. Conclusion Eyelid swelling is the typical symptom of BLEL. Most of cases involve bilateral lacrimal gland. Although MRI has high value for diagnosing BLEL, confirmed diagnosis mainly depends on pathological examination.%目的 探讨泪腺良性淋巴上皮病变(BLEL)的临床特点和诊断方法.方法 回顾性系列病例研究.收集2010年8月至2011年10月间经病理证实的泪腺BLEL患者资料16例,分析和总结其临床特点、影像学表现及实验室检查结果.结果 16例患者中男∶女=1∶7；年龄为36～63岁,其中以41～50岁为多；单眼发病:双眼发病=1∶7；上眼睑无痛性非充血性持续肿胀为其主要临床表现.眼眶MRI成像扫描显示,16例患者病变均累及眼睑和泪腺组织,受累泪腺明显肿大,T1WI和T2WI均呈等信号,增强扫描可见明显均匀强化,另外,3例患者眼外肌受累,1例颞肌受累,1例额神经受累；实验室检查仅1例患者丙肝抗体阳性,余未见异常.结论 眼睑肿胀是BLEL的典型症状,受累泪腺以双侧居多；MRI成像检查在诊断BLEL中具有重要价值,但确诊该病需要有病理组织学检查结果的支持.