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…     

CT和MRI对泪腺混合瘤的临床应用价值

目的:探讨CT,MRI对泪腺混合瘤的临床应用价值。方法:对术前行CT或MRI检查,术后经病理证实为泪腺混合瘤17例进行分析。结果:术后随访6mo～10a,14例未复发,3例复发(18%),1例为外院术前未行CT或MRI检查。结论:CT,MRI对泪腺混合瘤具有准确的定位、定性诊断价值,对手术入路选择、手术设计及术前准备也有着重要指导意义,对指导初次手术中连同包膜一次性完整切除病变,减少复发率,具有重要意义。     

眼睑泪腺混合瘤1例

患者　女　 46岁　左眼上睑肿物逐渐增大 6年 ,无红肿、压痛 ,曾在当地医院诊断为“霰粒肿” ,给予点眼治疗未愈。近半年缓慢增大。即往史右眼曾于 8岁时患“眼病”后失明。查体 ,全身未见异常 ,视力 :右 :无光感 ,左 1 0。左眼上睑中外 1/ 3交界处部位局限隆起 ,皮肤无红肿 ,肿物外观约1 5cm× 2cm大小 ,表面光滑 ,质韧 ,无压痛 ,与周围组织无粘连 ,睑球结膜均无充血 ,眼球无突出凹陷 ,向各个方向转动正常。角膜清亮 ,前方轴深正常 ,瞳孔正圆 ,对光反应灵敏眼底未见异常 ,X线眼眶片未见异常 ,B超显示左眼上睑颞侧可探及 1 5cm× 1 8cm低回…     

泪腺脱垂35例临床分析

泪腺脱垂在临床上并非罕见,其特征为:双上睑肿胀,颞上方眶缘下皮肤星轻度隆起状态,且可于该部位触及一活动性、无压疼、分叶状,能还纳入泪腺窝的团块,皮肤松弛变薄、下垂。现将我科近10年来遇到的35例住院病人临床分析如下: 临床资料 35例中,一般体格检查及血尿常规检查均正常。其中1例患副鼻窦炎,眼前节及眼底     

幼儿泪腺混合瘤一例

阿×男3岁以左眼眶缘发现肿物2月,伴眼痛1月为主诉来就医,以左眼眶肿物收入院。因患儿不合作,准确视力无法了解。左眼外上方眶内可触及约0.8cm×0.8cm大小的肿物,其表面皮肤未见发红,质地较硬,表面光滑,活动度欠佳,有轻度触痛,边界尚清,眼睑活动及眼球活动未受限制。眼前节及后节未见异常。浅表淋巴结未触及。心肺(正常)。     

右下睑异位泪腺混合瘤一例

患者女性，14岁，发现右下睑肿物5年来，无痛、无出血或破溃，曾于2年前就诊于当地医院，诊断为“右下睑肉芽肿”，行右下睑肿物切除术，术后检查结果不详。术后3个月再次在原位置发现下睑肿物，未行系统诊治。     

298例泪腺上皮性肿瘤临床特征及组织病理学分析

目的探讨泪腺上皮性肿瘤的临床特征与组织病理学类型之间的关系，旨在为临床提供较为可靠的诊断依据。方法回顾总结北京同仁医院眼病理室44年间（1961年～2005年1月）存档的298例泪腺上皮性肿瘤的临床及病理资料，进行统计学分析。结果298例肿瘤中，最常见的为泪腺多形性腺瘤，其它依次为腺样囊腺癌，腺癌，多形性腺癌及其它泪腺少见肿瘤。对不同类型肿瘤发病年龄、性别及眼别进行比较，差异均无显著性意义。对其发病时间进行比较，差异具有显著性意义。结论根据病史、临床表现、影像学检查，可对多数病例做出初步诊断，有助于临床医生正确选择治疗方案。     

Lacrimal scintillography: Advances and functional applications

The more precise evaluation of excretory function of the lacrimal system was made possible in 1972 with the advent of lacrimal scintillography. Two significant recent advances involving the computerization of scanning are presented. Rapid sequence display, a qualitative, dynamic method of viewing excretory function, and immediately available quantitative computcrized $\text{T}\text{-}\text{1}\text{2}$ values improve the interpretive abilities of lacrimal scintillography. Various clinical entities investigated in this manner have been studied with dacryocystography, an anatomical exam, to confirm scintillography's ability in identifying functional pathology. We have been able to virtually eliminate false results and we recommend its use in selected lacrimal excretory investigation.     

The Association of Lacrimal Gland Inflammation with Alopecia Areata

Purpose: To describe the association of lacrimal gland inflammation with alopecia areata.

Methods: We reviewed the medical records of 4 patients diagnosed with lacrimal gland inflammation who had an antecedent or subsequent episode of alopecia. Data was collected on the presentation age, gender, medical history, disease onset, symptoms and signs, imaging, histopathology, systemic evaluation, management and outcome. Pathology and imaging results were correlated with clinical findings.

Results: Three patients were Asian and one Caucasian. Two developed alopecia after presentation for lacrimal inflammation. The remaining two had a history of alopecia totalis (2 years and 10 years). Three of the 4 patients presented or developed other systemic disorders, including seizures, thrombocytopenia, optic neuritis, ulcerative colitis, allergic rhinitis, lymphadenopathy, vasculitic rash and positive p-ANCA values. All received oral corticosteroids, with the addition of methotrexate therapy in one for relapsing inflammation.

Conclusions: Lacrimal gland inflammation and alopecia areata are autoimmune processes that can be seen in association with each other.     

Lacrimal Drainage System Obstruction

The lacrimal drainage system consists of the lacrimal puncta, inferior and superior canaliculi, common canaliculus, lacrimal sac, and nasolacrimal duct. It is classically divided into upper and lower portions. Obstruction of the drainage system can be congenital or acquired, and may result in persistent epiphora and mucopurulent discharge. This paper discusses the etiology, clinical picture, diagnosis, and surgical treatment of lacrimal drainage system obstruction.     

泪腺多形性腺瘤ras癌基因产物表达与DNA含量的关系

目的:泪腺多形性腺瘤是常见的泪腺肿瘤,约占上皮性肿瘤的50％。手术后常有复发,恶性变也不少见。以往的研究表明,肿瘤的发生发展与癌基因产物的异常表达有关。本研究的目的是观察泪腺多形性腺瘤是否存在有P~(21ras)的异常表达。方法:研究采用免疫组化ABC法测定5例正常泪腺组织及32例多形性腺瘤P~(21ras)的表达,抗体选用单克隆抗体F—132—62。肿瘤细胞核DNA含量测定采用计算机图像分析技术。结果:正常泪腺组织均染色阴性,12例肿瘤染色阳性。14例肿瘤细胞核DNA含量增加,其倍体分布类型呈双峰及多峰型。P~(21ras)表达与肿瘤细胞DNA含量倍体分布类型明显相关,在P~(21ras)染色阳性的肿瘤,DNA含量倍体分布类型主要为双峰及多峰型,经精确概率x~2检验,差异有显著性,P<0.05。结论:本研究的结果提示,泪腺多形性腺瘤有P~(21ras)的增强表达,P~(21ras)的异常表达与肿瘤的发展有关。眼科学报 1996;12;54—57。     

Primary Malignant Mixed Tumors of the Lacrimal Gland: Report of 10 Cases

Ten consecutive cases of malignant mixed tumor (pleomorphic adenocarcinoma) primary in the lacrimal gland were studied for clinical features, pathology, course and prognosis, and surgical management. Long-term follow-up data were available on all patients and emphasized the malignant nature of the neoplasm. Survival intervals after the initial operation varied and seemed dependent on whether the neoplasm was initially histologically malignant or became malignant during the recurrence of a benign mixed tumor. An en bloc, one-stage removal of neoplasm with attached periorbita and underlying bone is recommended to minimize early dissemination via bone.     

泪囊黏液囊肿的鼻泪管支架植入治疗观察

目的 评价鼻湘管支架植入术在治疗泪囊黏肿中的应用价值。方法 对21例（21眼）泪囊黏滚囊肿患者行鼻泪管支架植入术，逆行扩张鼻泪道后植入特制的鼻泪管支架，术前术后行数字减影泪道造影检查，分析其疗效。结果 21眼均成功植入鼻泪管支架，手术成功率为100%，术后随访2—43个月，有效率为100%。无严重并发症的发生。结论 鼻泪管支架植入术治疗泪囊黏液囊肿操作简便，具有良好的临床效果，值得推广。     

眼部不适患者309例的泪液学分析

目的 通过对309例眼部不适患者的泪液学分析,以指导治疗。方法 对309例患者均做Schirmer’s试验,眼表上皮 细胞活体染色,泪膜破裂时间(BUT)。结果 244例患者平均泪液分泌量<10mm,242例患者存在表层点状角膜病变,268例 患者泪膜破裂时间缩短。结论 该组患者泪液分泌量明显不足,角结膜破损程度较重,泪膜破裂时间缩短,泪膜稳定性下降。     

原发性泪腺上皮性肿瘤患者97例诊治分析

目的　探讨泪腺上皮性肿瘤的临床表现、影像学特征、诊断方法及治疗原则。方法　对２００３年１月至２０１４年１０月在河南省眼科研究所就诊的９７例泪腺上皮性肿瘤的临床表现、影像学检查、治疗方法、术后视力、及随访情况等临床资料进行回顾性分析。采用前路开眶１１例,常规外侧开眶１９例,改良“Ｓ”形皮肤切口并外侧开眶６７例。结果　９７例泪腺上皮性肿瘤中,泪腺多行性腺瘤６５例（６７．０１％）,腺样囊性癌１６例（１６．４９％）,多形性腺癌１２例（１２．３７％）,腺癌２例（２．０６％）,黏液表皮样癌１例（１．０３％）,肌上皮瘤１例（１．０３％）。术后视力提高３７例,无变化５４例,下降６例。１３例出现眼球内陷,早期上睑下垂１１例,４例出现外展运动受限、水平复视。术后６个月随访:上睑下垂４例;１例出现永久性外展不足、水平复视。结论　泪腺上皮性肿瘤具有典型的临床表现和特征性的影像学改变,术前通过准确的定位来选择适宜的手术进路,可顺利并完整地切除肿瘤,避免肿瘤复发和出现严重并发症。