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[眼眶嗜酸性淋巴肉芽肿的临床病理观察]

[The clinicopathologic observation of eosinophilic hyperplastic lymphogranuloma in the orbit].

作者信息

Lin Jin-Yong, Zhao Hong, Yang Zhen-Hai

机构信息

Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Institute, Clinical College of Ophthalmology Tianjin Medical University, Tianjin 300020, China.

出版信息

Zhonghua Yan Ke Za Zhi. 2011 May;47(5):427-30.

Abstract

OBJECTIVE

To improve the knowledge of the clinicopathologic features of eosinophilic hyperplastic lymphogranuloma (Kimura disease) in the orbit.

METHODS

It was a retrospective case series study. The clinical and pathological characteristic of 9 cases of Kimura disease from the pathology department of Tianjin Eye Hospital were reviewed, immunohistochemical staining was performed, including for CD20, D79a, CD3, CD45Ro, CD34, Ki67 and IgE.

RESULTS

In the 9 cases, 7 cases were male, 2 cases were female; the age of onset were from 13 to 62 years, medium age was 25 years; 7 cases were simple, 2 case were bilateral orbit. These lesions occurred in the superior or superotemporal quadrant of the orbit and the majority of cases extended into deep orbital tissues, 6 cases involved the lacrimal gland, 5 case involved the lateral rectus muscle. The clinical features mainly included lid swelling, eye redness, proptosis and palpable mass, and the disease course ranged from 6 months to 15 years. 3 lymph node enlargements in the submandibular regions and 1 subcutaneous nodule on the bilateral elbow were found in one case. The documentation of peripheral-blood eosinophilia (11% - 14%) was found in 3 cases. The pathological characteristics of Kimura disease were lymphoid tissue hyperplasia with prominent lymphoid follicles, conspicuous eosinophils infiltration and capillary proliferation. Immunohistochemical study in our cases revealed B cells in lymphoid follicles and mostly T cells in the interfollicular regions.

CONCLUSION

Kimura disease of orbit is an uncommon lymphoid hyperplasia with prominent eosinophils infiltration and capillary vessels, which commonly occur superotemporal quadrant of the orbit, easy to involve lacrimal gland and lateral rectus muscle.

摘要

目的

提高对眼眶嗜酸性粒细胞增生性淋巴肉芽肿(木村病)临床病理特征的认识。

方法

这是一项回顾性病例系列研究。回顾了天津眼科医院病理科9例木村病的临床和病理特征,进行了免疫组织化学染色,包括检测CD20、D79a、CD3、CD45Ro、CD34、Ki67和IgE。

结果

9例中,男性7例,女性2例;发病年龄13~62岁,中位年龄25岁;单眼7例,双眼眶2例。这些病变发生于眼眶上象限或颞上象限,大多数病例延伸至眼眶深部组织,6例累及泪腺,5例累及外直肌。临床特征主要包括眼睑肿胀、眼红、眼球突出和可触及肿块,病程6个月至15年。1例患者在双侧肘部发现3个下颌下区淋巴结肿大和1个皮下结节。3例患者外周血嗜酸性粒细胞增多(11%~14%)。木村病的病理特征为淋巴组织增生伴明显的淋巴滤泡、显著的嗜酸性粒细胞浸润和毛细血管增生。我们病例的免疫组织化学研究显示淋巴滤泡中有B细胞,滤泡间区域主要为T细胞。

结论

眼眶木村病是一种罕见的淋巴增生性疾病,伴有显著的嗜酸性粒细胞浸润和毛细血管增生,常发生于眼眶颞上象限,易累及泪腺和外直肌。

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