Schnabl Christina, Kühn Christian, Rustemeyer Jan
Department of Oral and Maxillofacial Surgery, Klinikum Bremen-Mitte, School of Medicine of the University of Göttingen, Bremen, Germany.
Oral Maxillofac Surg. 2015 Dec;19(4):433-6. doi: 10.1007/s10006-015-0514-5. Epub 2015 Jun 23.
Entities of lacrimal gland lesions comprise almost inflammatory and lymphoproliferative processes as well as benign and malignant solid tumors and usually cannot be differentiated by magnetic resonance imaging (MRI) exclusively. Hence, representative tissue samples are needed to arrive at sufficient histopathological diagnosis for further treatment decisions.
Three women aged between 18 and 67 years were admitted to our center with clinical signs of a space-occupying mass in the lacrimal fossa. MRI revealed a circumscribed lacrimal gland lesion in all three cases. The orbital lobe was resected through a lateral orbitotomy approach for histopathological evaluation. Findings confirmed the diagnoses of pleomorphic adenoma, dacryoadenitis, and low-grade B cell non-Hodgkin's lymphoma. Further surgery was not necessary. No recurrence or symptoms of "dry eye" were observed over the course of a 1-year follow-up.
In cases of non-specific masses in the lacrimal gland on MRI, histopathological diagnoses are vital and can be sufficiently provided by resection of the orbital lobe. Symptoms of dry eye are uncommon, and secondary surgical intervention can be avoided in cases of the presented entities. Further studies with larger patient cohorts are warranted to confirm these findings.
泪腺病变几乎包括炎症和淋巴增殖性病变以及良性和恶性实体肿瘤,通常不能仅通过磁共振成像(MRI)进行鉴别。因此,需要代表性的组织样本以获得充分的组织病理学诊断,从而做出进一步的治疗决策。
三名年龄在18至67岁之间的女性因泪腺窝占位性肿块的临床症状入住我院。MRI显示所有三例均为边界清楚的泪腺病变。通过外侧眶切开术切除眶叶以进行组织病理学评估。结果确诊为多形性腺瘤、泪腺炎和低度B细胞非霍奇金淋巴瘤。无需进一步手术。在1年的随访过程中未观察到复发或“干眼”症状。
对于MRI显示泪腺非特异性肿块的病例,组织病理学诊断至关重要,切除眶叶可充分提供诊断。干眼症状并不常见,对于本文所述的病变可避免二次手术干预。有必要进行更大患者队列的进一步研究以证实这些发现。