泪腺多形性腺瘤转铁蛋白受体表达的研究

泪腺多形性腺瘤转铁蛋白受体表达的研究上海第二军医大长海医院眼科郑磊，何淑芳，韩传贵沈阳军区总医院眼科范忠义铁在细胞生长和生存中是必不可少的川，参与细胞内的多种代谢，包括氧比磷酸化和ＲＮＡ、ＤＮＡ的合成“’，细胞对铁的摄取依赖于血浆中的转铁蛋白和细胞表...     

良恶性泪腺多形性腺瘤电镜观察

目的：为进一步探讨泪腺上皮性肿瘤术后易复发、预后差的形态学发生机理。方法：应用JEM-100CX型投射电镜及光镜观察12例良恶性泪腺上皮性肿瘤的细胞超微结构和异质性及电镜下侵犯包膜的不同方式。结果：(1)良性多形性腺瘤细胞间存在着桥粒、连接复合体等,符合上皮来源。(2)恶性肿瘤细胞胞浆中含有较多的溶酶体、微丝并伸出细长伪足向周围组织及包膜浸润,有较强侵袭力。(3)良性多形性腺瘤伴包膜浸润时伸出钝而圆的伪足且溶酶体比周围组织明显增多。结论：上述肿瘤细胞超微形态结构变化可能与此类肿瘤易复发、预后差的临床生物学行为有关：利用光镜结合电镜观察对良性多形性腺瘤的预后监测有重要意义,当发现包膜浸润时临床应密切随访。     

泪腺多形性腺瘤误诊一例报告

1病例患者,女,35岁,农民。左眼流泪、异物感3年,无头痛、眼痛、视物模糊或复视。曾多次到外院就诊,均诊为“左眼下睑内翻、倒睫”,给予拔睫毛、滴消炎滴眼液治疗。治疗后,症状即缓解,但病情反复发作。2010年7月15日又因上述症状到我院就诊。查体：双眼视力1．0,眼压正常。左眼结膜无充血,角膜透明,前房中深,瞳孔圆,对光反应存在。眼底：     

良恶性泪腺多形性腺瘤电镜观察

目的:为进一步探讨泪腺上皮性肿瘤术后易复发、预后差的形态学发生机理.方法:应用JEM-100CX型投射电镜及光镜观察12例良恶性泪腺上皮性肿瘤的细胞超微结构和异质性及电镜下侵犯包膜的不同方式.结果:(1)良性多形性腺瘤细胞间存在着桥粒、连接复合体等,符合上皮来源.(2)恶性肿瘤细胞胞浆中含有较多的溶酶体、微丝并伸出细长伪足向周围组织及包膜浸润,有较强侵袭力.(3)良性多形性腺瘤伴包膜浸润时伸出钝而圆的伪足且溶酶体比周围组织明显增多.结论:上述肿瘤细胞超微形态结构变化可能与此类肿瘤易复发、预后差的临床生物学行为有关;利用光镜结合电镜观察对良性多形性腺瘤的预后监测有重要意义,当发现包膜浸润时临床应密切随访.     

泪腺多形性腺瘤肿瘤成分的计算机定量分析

在提出了泪腺多形性腺瘤亚型分类标准的基础上，利用计算机图像分析系统，对１１例病理标本诸亚型的肿瘤成分和包膜厚度进行了定量分析。这一方法减小了人为因素对病理亚型分类的影响，有利于进行病例追踪、肿瘤复发、恶变因素的定量分析，为亚型分类诊断提供了量化依据。提示此图像定量分析方法在眼肿瘤病理定量研究中有广泛应用前景。     

复发性泪腺多形性腺瘤临床特征分析及相关凋亡因子研究

目的 对复发性多形性腺瘤的临床特征等进行分析并对其表达的相关凋亡因子survivin和caspase-3进行研究.方法 收集2003年1月至2007年1月期间住院的泪腺多形性腺瘤、复发性多形性腺瘤及腺样囊性癌患者的临床资料,对这些患者术后的石蜡包埋标本进行survivin和caspase-3免疫组化染色.结果 复发性多形性腺瘤多表现眶壁骨质破坏及边界不规则的特点;survivin表达方面,复发性多形性腺瘤与初次手术的多形性腺瘤之间差异有统计学意义(P＜0.05),而与腺样囊性癌之间差异则无统计学意义(P＞0.05); caspase-3表达方面,各组之间差异无统计学意义(P＞0.05); Survivin与caspase-3之间呈负相关(r=-0.995,P＜0.05).结论 复发性泪腺多形性腺瘤虽然在病理上表现为良性,但在生物学行为上则是恶性肿瘤的表现,治疗上应多从该肿瘤的恶性生物学行为方面进行考虑;survivin的高表达与caspase-3的低表达可能在泪腺多形性腺瘤的复发中具有重要作用.     

泪腺多形性腺瘤细胞核形态及DNA含量的测定

应用计算机图像分析技术对３２例泪腺多形性腺瘤（其中１０例恶性变）进行了细胞核形态及ＤＮＡ含量的测定，结果在细胞核形态的七项指标中，仅最大径和最小径在良性及恶性变肿瘤之间相差显著，而ＤＮＡ含量，恶变肿瘤明显高于良性肿瘤，ＤＮＡ含量倍体分布类型在恶变肿瘤以双峰和多峰为多，提示在泪腺多形性腺瘤ＤＮＡ含量增加，并呈双峰和多峰分布是肿瘤生物学特性发生改变的重要时期。     

泪腺多形性腺瘤或癌DNA含量和P^53基因产物表达的定量分析

应用流式细胞计量术和免疫荧光染色技术,对１８例多形性腺瘤和６例多形性腺癌细胞的ＤＮＡ含量及Ｐ５３基因产物表达进行定量测定,探讨其在该肿瘤病理学诊断中的意义。结果表明,多形性腺瘤具有正常泪腺细胞的ＤＮＡ二倍体含量;多形性腺癌以ＤＮＡ异倍体为特征;Ｐ５３...     

泪腺良性多形性腺瘤多次复发

泪腺多形性腺瘤的复发与恶变的机会较多 ,但临床所见确定有复发多次经病理检查证实仍属良性多形性腺瘤的病例 ,今 1例报告如下 :患者李×× ,男 ,68岁 ,教师 ,住院号 2 0 40 95。1970年以左眼球逐渐突出 1年余为主诉到我院就诊 ,无视力下降及眼痛感觉。检查 :双眼视力 1 2 ,左眼球中度突出 ,向内下方移位 ,左眼睑轻度肿胀 ,眶外上方可扪及中等硬度肿物 ,表面光滑 ,不活动 ,无触痛。眼球向外上方运动受限 ,屈光间质清晰 ,眼底正常 ,Ｘ线拍片所见眶腔扩大 ,泪腺向外上方膨隆 ,边界清晰完整无骨质破坏。临床诊断为左眼泪腺混合瘤 ,在肉眼局麻下…     

泪腺上皮性肿瘤113例临床病理学分析

目的 探讨泪腺上皮性肿瘤组织病理学类型和临床特征.方法 回顾性病例研究重新复习天津眼科医院病理科自1980年至2009年间收检的113例泪腺上皮性肿瘤的临床和病理学资料,参照WHO关于唾液腺肿瘤的分类和诊断标准,分析泪腺上皮性肿瘤的类型和临床病理学特点.结果 113例泪腺上皮性肿瘤中,多形性腺瘤73例(64.6%),腺样囊性癌23例(20.4%),癌在多形性腺瘤中9例(8.0%),其他类型的上皮性肿瘤均为恶性,共8例(7.0%).结论 泪腺上皮性肿瘤有不同的病理类型,其临床特点、治疗和预后有很大区别,正确和详细的病理诊断可对临床治疗起到指导意义.     

In situ adenocarcinoma ex pleomorphic adenoma of the lacrimal gland

A case of an in situ adenocarcinoma of the lacrimal gland that developed in a recurring pleomorphic adenoma is presented. Six years after incomplete resection of a pleomorphic adenoma, the patient complained of a progressive swelling of her right upper eyelid without pain or diplopia. An orbital computerized tomography scan showed an inhomogeneous mass in the right lacrimal gland region without bone involvement. After local excision of the in situ adenocarcinoma ex pleomorphic adenoma, the tumour has been in control for over 6 years.     

Clinical analysis of 109 cases of lacrimal gland pleomorphic adenoma

AIM: To monitor the prognosis of patients with lacrimal gland pleomorphic adenoma (LGPA) following surgical resection within the past 10y. The factors affecting patient prognosis are analyzed and the experience of surgical treatment is summarized. METHODS: In this retrospective, comparative case series, clinical records from 109 cases of LGPA treated chiefly at the same institution between November 2009 and May 2019 were reviewed. All 109 patients underwent surgery, histopathological examination, and imaging examination. For patients who underwent surgery for the first time, LGPA could be resected completely, including tumor and capsule tissues, using a surgical approach via the eyebrow arch or double eyelid crease. RESULTS: The ratio of males to females was 1:1.60, the ages ranged from 19 to 74 years old with a mean age of 43.64±13.07 years old, and the ratio of left to right eyes was 1:1.37. A total of 109 patients underwent surgical excision and five of these received radiotherapy after malignant transformation. Of these patients, 15 were lost to follow up within the April 1, 2020 deadline and 1 was diagnosed as a recurring pathology. The 5-year recurrence rate for 86 patients who underwent initial surgery was 7.27%. Single factor analysis revealed that the course of disease, bone destruction, invasion of surrounding tissues, tumor size, capsule integrity, and expression of Ki-67 were statistically significant (P<0.05). Binomial Logistic regression analysis showed that capsule integrity was a risk factor influencing recurrence (P=0.008). CONCLUSION: LGPA has a risk of recurrence and potential for malignant transformation. Complete removal of the tumor and capsule in the initial surgery is a key factor in preventing recurrence.     

Giant pleomorphic adenoma of the lacrimal gland: A surgical challenge

Pleomorphic adenoma is the most common epithelial neoplasm of the lacrimal gland. The tumor typically presents with a superotemporal mass with inferonasal displacement of the globe. They generally measure less than 3 cm in size and can be removed comfortably via a lateral orbitotomy approach. Pleomorphic adenoma left unattended for a long period grows up to humongous proportions and poses a surgical challenge both for its complete removal and globe salvage. We report a rare case of pleomoprphic adenoma of the lacrimal gland in an adult male, who did not seek any medical advice for 20 years allowing the tumor to expand enormously in all dimensions, with complete obscuration of the globe. The tumor was excised completely and globe could be salvaged.     

Immunohistochemical features of carcinoma ex pleomorphic adenoma and pleomorphic adenoma in the lacrimal gland

AIM: To investigate C-myc, Ki-67, pan-cytokeratin, and vimentin immunohistochemical features of carcinoma ex pleomorphic adenoma (Ca-ex-PA) and pleomorphic adenoma (PA) in the lacrimal gland in order to find some clues in the differential diagnosis between them. METHODS: We reviewed microscopic slides and clinical records of 64 cases of PA and 15 cases of Ca-ex-PA in the lacrimal gland. Immunohistochemical antibodies for C-myc, Ki-67, pan-cytokeratin, and vimentin were employed. RESULTS: Median age of PA was 43.2y (from 21 to 75). The 35 patients (54.7%) were male and 29 patients (45.3%) were female. For the PAs, the average positivity of C-myc was 4.6%; the average proliferation index of Ki-67 was 3.2%; pan-cytokeratin was positive in ductal cells, and vimentin was positive in myoepithelial cells. Median age of Ca-ex-PA was 54.3y (from 26 to 76). There were 7 male patients (46.7%) and 8 female patients (53.3%). Among 15 Ca-ex-PAs, there were 6 myoepithelial carcinomas, 4 adenocarcinomas, 3 epithelial-myoepithelial carcinomas, and 2 squamous cell carcinomas. For the Ca-ex-PAs, the average positivity of C-myc was 36.4%; the average proliferation index of Ki-67 was 29.2%; pan-cytokeratin was positive in all cases, and vimentin was positive in myoepithelial carcinomas. CONCLUSION: PA has a lower positivity of C-myc and Ki-67, while Ca-ex-PA had a higher positivity of these two biomarkers. These four biomarkers as a set could provide valuable clues in the differential diagnosis between Ca-ex-PA and PA. Our results indicate that the activation of C-myc could play an important role in the pathogenesis of Ca-ex-PA and PA.     

Slow-growing large pleomorphic adenoma of ectopic lacrimal gland tissue in the upper eyelid

A few cases of pleomorphic adenoma of an ectopic lacrimal gland involving the deep orbit and lateral canthus have been previously reported. A 75-year-old female with a slow-growing, large pleomorphic adenoma arising from ectopic lacrimal gland tissue in the left upper eyelid is described in the present case report.     

Mucoepidermoid carcinoma ex pleomorphic adenoma of the lacrimal gland: A rare presentation

Carcinoma ex pleomorphic adenoma in lacrimal gland is a rare entity unlike its salivary gland counterpart. This rare tumor poses a diagnostic challenge to clinicians as pre-operative diagnosis is difficult and diagnosis is only by careful pathological assessment. We report this uncommon lesion in a 62-year-old lady, wherein the malignant component was mucoepidermoid carcinoma. The elderly patient remained clinically and radiologically free of the tumor for two years after complete excision of the tumor but computed tomography at the end of two and a half years showed a recurrent lesion in the region of the lacrimal gland. This makes long term follow up of patients with these rare lacrimal tumors imperative with a minimum period of at least five years.