眼眶淋巴瘤的分类及临床病理分析

目的 初步探讨根据WHO淋巴造血系统肿瘤新分类标准对眼眶淋巴瘤进行分型及分析不同类型眼眶淋巴瘤的临床病理特点.方法 收集2002年1月至2006年6月经手术和组织病理学检查确诊的78例眼眶淋巴瘤患者的临床和病理资料,根据WHO淋巴造血系统肿瘤新分类标准进行分类,进一步分析其临床病理特点,治疗方案及预后.结果 78例眼眶淋巴瘤均为非霍奇金淋巴瘤(NHL),其中77例为B细胞来源(98.7%),包括黏膜相关淋巴组织边缘区B细胞淋巴瘤(MALT淋巴瘤)71例(91.0%),髓外浆细胞瘤3例(3.8%),滤泡性淋巴瘤1例(1.3%),弥漫大B细胞淋巴瘤1例(1.3%),前驱B淋巴母细胞性淋巴瘤1例(1.3%);1例为T细胞来源,为非特殊性周围T细胞性淋巴瘤(1.3%).MALT淋巴瘤经局部放疗后肿瘤明显消退,孤立性髓外浆细胞瘤经局部放疗后病情稳定,滤泡性淋巴瘤和弥漫大B细胞淋巴瘤行全身化疗和局部放疗后病情得到控制.前驱B淋巴母细胞性淋巴瘤和非特殊性周围T细胞性淋巴瘤恶性程度较高,患者均于短期内死亡.结论 眼眶淋巴瘤因其类型不同而恶性程度和临床表现不同,治疗和预后也各异,故根据WHO淋巴造血系统肿瘤新分类标准对眼眶淋巴瘤进行分类具有重要意义.

Classification and clinicopathological analysis of orbital lymphoma

Objeetive To investigate the orbital lymphoma subtypes according to the new classification of the World Health Organization(WHO)and analyze the clinicopathologic features of the different type of orbital lymphoma.Methods A total of 78 cases of orbital lymphoma treated and diagnosed at EENT hospital from January 2002 to June 2006 have been classified using the WHO classification of lymphoma and analyze their clinicopathologic features,treatment and prognoses.Results All the 78 cases were confirmed to be nonHodgkin lymphoma and 77 cases(98.7%)were of B-cell lineage.Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue(MALT lymphoma)is the most commonest(71 case,91.0%),followed by extramedullary plasmacytoma(3 cases,3.8%),follicular lymphoma(1 case,1.3%),diffuse large B-cell lymphoma(1 case,1.3%),precursor B-lymphoblastic lymphoma(1 case,1.3%).1 case(1.3%)of T-cell lineage was peripheral T-cell lymphoma.MALT lymphoma of orbit showed gradual regression treated with local radiotherapy and have a favorable prognosis.Solitarullary plasmacytoma responded to local radiation alone and had no recurrence.Follicular lymphoma and diffuse large B-cell lymphoma responded to local radiation and systemic chemotherapy without disease aggression.The patient of precursor B-lymphoblastic lymphoma and peripheral T-cell lymphoma died of progression of the disease in a short time.Conclusions Various types of lymphoma have different degree of malignancy,clinical manifestation,treatment and prognosis,so the classification of orbital lymphoma is very important.