眼附属器淋巴瘤的临床病理分析

目的：探讨眼附属器淋巴瘤(OAL)的发病情况、临床表现及病理分型，以提高临床诊治水平。

方法：选取2005-08/2013-07在华西医院眼科确诊的OAL患者147例，收集患者的一般情况、临床表现、临床检查(影像学、病理学)结果、治疗及预后情况等临床资料进行回顾性研究。

结果：本研究纳入OAL患者147例，其中男91例(61.9%)，女56例(38.1%)； 年龄3.5～87岁； 病程20d～10a； 发病部位以眼眶最多见(106/147)； 最常见的临床表现为眼部包块、眼睑肿胀、眼球突出； 病理分型以黏膜相关淋巴组织边缘区B细胞淋巴瘤最多见(112/147)，且其预后最好，而弥漫大B细胞淋巴瘤、结外NK/T细胞淋巴瘤，鼻型预后最差。

结论：OAL病理类型复杂，发病部位和临床表现多样，免疫组织化学染色是OAL鉴别诊断的重要依据，其预后与病理类型密切相关。

Clinical pathological analysis of ocular adnexal lymphoma

AIM: To study the incidence, clinical features and pathological types of ocular adnexal lymphoma(OAL), in order to improve the level of clinical diagnosis and treatment.

METHODS: There were 147 cases of OAL in West China Hospital from August 2005 to July 2013. We collected clinical data such as general conditions, clinical manifestations, clinical examination(imaging, pathology)results, treatment and prognosis for retrospective study.

RESULTS: This study consist of 147 patients with OAL, including 91 males(61.9%)and 56 females(38.1%); aged from 3.5 to 87 years old; the course of disease range from 20d to 10a; the most common location of disease is orbit(106/147).The most common clinical manifestations including ocular mass, eyelid swelling and exophthalmos. Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue were most common(112/147), it also had the best prognosis while diffuse large B-cell lymphoma, extranodal NK/T-cell lymphoma,nasal type showed the worst prognosis.

CONCLUSION: The pathological types of OAL were complex, which also had diverse location of disease and clinical manifestations. Immunohistochemically staining is an important basis for the differential diagnosis of OAL, and the prognosis of which is closely related to pathological type.