Couceiro Rita, Loureiro Cláudia, Luís Pedro, López-Presa Dolores, Proença Helena, Fonseca Ana, Monteiro-Grillo Manuel
Department of Ophthalmology, Hospital de Santa Maria, Lisbon, Portugal.
Department of Pathology, Hospital de Santa Maria, Lisbon, Portugal.
Clin Ophthalmol. 2014 Oct 7;8:2061-4. doi: 10.2147/OPTH.S69047. eCollection 2014.
To report a rare case of lacrimal gland carcinoma ex pleomorphic adenoma (Ca ex PA) with chronic B-cell lymphocytic leukemia (B-CLL) infiltration in a patient without a previous diagnosis of B-CLL.
We report a 66-year-old woman who presented with recent worsening of a long-standing right eye proptosis. Sequential orbital computed tomography imaging was performed over the course of 2 years, and biopsy specimens were analyzed.
Initial computed tomography scans revealed a lacrimal gland lesion with stable dimensions for more than 1 year and no malignancy features on incisional biopsy. Subsequently, lesion volume growth and bone erosion were documented on orbital computed tomography. Lateral orbitectomy and lacrimal gland resection were performed. Pathology and immunohistochemistry detected Ca ex PA with B-CLL infiltration.
This case highlights the importance of persistent investigation of clinically suspicious orbital lesions. To our knowledge, this is the first description of a case of lacrimal gland Ca ex PA with B-CLL infiltration.
报告1例泪腺多形性腺瘤恶变（Ca ex PA）合并慢性B淋巴细胞白血病（B-CLL）浸润的罕见病例，该患者既往无B-CLL诊断。
我们报告1例66岁女性，其长期存在的右眼突眼近期加重。在2年的病程中进行了系列眼眶计算机断层扫描成像，并对活检标本进行了分析。
最初的计算机断层扫描显示泪腺病变，其大小在1年多时间内稳定，切开活检未发现恶性特征。随后，眼眶计算机断层扫描记录到病变体积增大和骨质侵蚀。进行了外侧眶切除术和泪腺切除术。病理及免疫组化检测发现泪腺Ca ex PA合并B-CLL浸润。
该病例突出了对临床可疑眼眶病变持续进行检查的重要性。据我们所知，这是首例泪腺Ca ex PA合并B-CLL浸润病例的描述。
