泪腺导管囊肿的临床研究

目的 探讨泪腺导管囊肿的发病机制、临床特点、影像学特点、鉴别诊断、组织病理学特点及治疗原则.方法 回顾性分析天津市眼科医院2003～2008年15例(15只眼)经手术后病理证实的泪腺导管囊肿患者.结果 所有患者均单眼发病,多以发现眼眶颞上方结膜下囊性肿物就诊,亦可伴眼部胀痛、异物感,眼球突出及移位,上脸下垂等,部分患者主诉情绪激动后肿物增大,可无眼部炎症、外伤及手术病史.B超及CT均显示囊性占位病变,少数可伴骨质受压变形或缺损.双层细胞构成囊壁为组织学诊断要点.结论 根据泪腺导管囊肿临床特点及影像学特征可基本明确诊断,但与结膜上皮性囊肿等鉴别仍需组织病理学最终确诊.最佳治愈方法为完整切除囊肿.该病发病机制仍有待进一步讨论.

The clinical research of Lacrimal gland duct cysts

Objective To approach the pathogenesis,clinical and imaging features,differential diagnosis,histopathology features and therapeutic principle of Lacrimal gland duct cysts.Methods Fifteen cases (15 eyes)of lacrimal gland duct cysts were analyzed retrospectively from 2003 to 2008 at Tianjin Eye Hospital.All the cases were diagnosed by postoperative pathologic diagnosis.Results Unilatemlity was occurred in all patients,who visited hospital because of hypoconjunctival cyst in the superior lateral quadrant of orbit,also may be with ocular gas pains,foreign body sensation,proptosis,eye-ball malposition and ptosis.Previous history of periocular inflammation,trauma or surgery was not necessary.B scan ultrasonography and computed tomography scans revealed a cystical mass with the appearance that orbital bone was compressed to deformation or defect in minority.Histodiagnosis feature was the cyst wall composed of double layer of epithelium.Conclusions Essentially lacrimal gland duct cysts can be diagnosed specifically by the clinical and imaging features,but it is difficult to discriminate from some cystical masses such as simple conjunctival cyst,postoperative pathologic diagnosis is necessary.The best therapeutic principle without recurrence is complete excision of the cyst.The pathogenesy still needs more discussion in the future.