大涎腺淋巴上皮病的临床分析

目的:探讨淋巴上皮病(lymphoepitheliallesion,LEL)流行病学特点以提高临床诊断准确率。方法:对19例淋巴上皮病病例的年龄、性别、病理类型、病程、临床和影像学表现、实验室检查结果、诊断情况进行回顾性分析。结果:淋巴上皮病发病年龄多在40～50岁左右,无性别差异。主要表现为局限性肿块或涎腺弥漫性肿大。肿块界清,直径0.6～4.6cm不等,活动度尚可,多数位于耳垂周围,良性者质地中等,恶性者质地较硬。一般无自发痛及面神经功能障碍,少数有轻压痛。无眼干、口干及关节疼痛等症状。淋巴上皮病可累及双侧腺体,绝大多数发生于大涎腺,腮腺最常见,且常呈多病灶。该病患者血清球蛋白往往升高,白球比下降。结论:淋巴上皮病的临床表现有一定规律性,结合影像学表现和实验室检查,可提高诊断率。

Clinical Analysis of Lymphoepithelial Lesion in Major Salivary Glands

Objective： To study the clinical characteristics of lymphoepithelial lesions and to improve the diagnosis. Methods： The location, duration, clinical and imaging manifestations, laboratory findings and the diagnosis of 19 lymphoepithelial lesion cases were retrospectively analyzed. Results： Lymphoepithelial lesion mostly occurred in adults aged about 40-50 years old, with no tendency for gender difference. The main manifestation of the disease were diffuse swelling of salivary glands or circumscribed mobile mass, measured 0.6-4.6 cm in diameter. Most masses located around the ear lobe. Benign lymphoepithelial lesion （BLEL） palpated soft and well-demarcated, while malignant lymphoepithelial lesion （MLEL） appeared relatively hard. There were no dry eyes, dry mouth, pain of the swelling, or palsy of the facial nerve. Lymphoepithelial lesion, which mostly involved major salivary glands and sometimes occurred in both sides, developed in parotid gland more frequently and often manifested as more than one mass. The serological findings showed that the quantity of globulin were easy to increase and the ratio of albumin to globulin （A-G） decrease. Conclusion： There are some characteristics of clinical manifestation of lymphoepithelial lesion. Assisted by imageology and laboratory examination, the diagnosis of lymphoepithelial lesion can be improved.