Winn Bryan J, Herreid Peter A, Sires Bryan S
Allure Facial Laser Center and Medispa, Kirkland, WA 98033, USA.
Ophthalmic Plast Reconstr Surg. 2009 Jul-Aug;25(4):341-3. doi: 10.1097/IOP.0b013e3181ab7479.
A 47-year-old woman presented with a painful mass below her left medial canthus. Examination revealed a 1-cm tender, smooth, pulseless, mobile mass inferior to the level of the anterior lacrimal crest. CT imaging was performed. Excision of the involved angular vein revealed a smooth, intralumenal lesion. Histopathologic examination demonstrated intravenous pyogenic granuloma (IVPG). There are approximately 30 reported cases of IVPG in the English literature, 2 of which arise in the periocular angular vein. The ultrasound and MRI characteristics of IVPG have been previously described. We describe the CT profile of this rare, benign tumor as a mildly heterogeneic, contrast-enhancing cylindrical lesion within, and conforming to the shape of, the angular vein. There is dilatation of the vein proximal to the lesion with marked narrowing distal to it secondary to obstruction of flow. On noncontrast imaging, the lesion is isodense with nasal mucosa and without calcifications.
一名47岁女性因左内眦下方出现疼痛性肿块前来就诊。检查发现泪前嵴水平以下有一个1厘米大小、触痛、表面光滑、无搏动、可活动的肿块。进行了CT成像检查。切除受累的角静脉后发现一个光滑的管腔内病变。组织病理学检查显示为静脉化脓性肉芽肿（IVPG）。英文文献中报道的IVPG病例约有30例，其中2例发生于眼周角静脉。IVPG的超声和MRI特征此前已有描述。我们将这种罕见的良性肿瘤的CT表现描述为角静脉内一个轻度异质性、有对比增强的圆柱形病变，其形状与角静脉相符。病变近端的静脉扩张，而远端因血流受阻明显变窄。在平扫成像上，病变与鼻黏膜等密度，无钙化。
