Ishikawa Eri, Takahashi Yasuhiro, Valencia Ma Regina Paula, Ana-Magadia Marian Grace, Kakizaki Hirohiko
Department of Oculoplastic, Orbital, and Lacrimal Surgery, Aichi Medical University Hospital, 1-1 Yazako-Karimata, Nagakute, Aichi, 480-1195, Japan.
Graefes Arch Clin Exp Ophthalmol. 2019 Feb;257(2):405-411. doi: 10.1007/s00417-018-4197-0. Epub 2018 Nov 28.
To examine the clinicopathological characteristics of patients with thyroid eye disease (TED) who showed asymmetric lacrimal gland enlargement.
Sixteen patients were included in this retrospective, observational case series. The following data were collected: sex, age, laterality, past medical history, laboratory results for thyroid function and other autoimmune disorders, pathological results, other systemic lesions related to lacrimal gland pathology, and the clinical course after treatment.
The results of pathological examinations were consistent with non-specific dacryoadenitis in seven patients, immunoglobulin G4-related dacryoadenitis in four patients, sarcoidosis in two patients, and xanthogranuloma in one patient, respectively. The remaining two patients were proven to be extra-nodal marginal zone lymphoma of mucosa-associated lymphoid tissue type (MALT lymphoma). One patient with sarcoidosis was noted to have another related systemic lesion. After treatment or observation, the lesions were either improved or stable in almost all patients, except for the two patients with MALT lymphoma.
Patients with TED who present with asymmetric lacrimal gland enlargement need to be further evaluated. Biopsy of the lacrimal gland and full systemic work-up should be considered as these may lead to detection of other pathological entities, especially malignancies, which could help in saving patients' lives.
研究表现为泪腺不对称肿大的甲状腺眼病（TED）患者的临床病理特征。
本回顾性观察病例系列纳入了16例患者。收集了以下数据：性别、年龄、患侧、既往病史、甲状腺功能及其他自身免疫性疾病的实验室检查结果、病理结果、与泪腺病理相关的其他系统性病变以及治疗后的临床病程。
病理检查结果分别为7例患者符合非特异性泪腺炎，4例患者符合免疫球蛋白G4相关泪腺炎，2例患者符合结节病，1例患者符合黄色肉芽肿。其余2例患者被证实为黏膜相关淋巴组织型结外边缘区淋巴瘤（MALT淋巴瘤）。1例结节病患者还存在另一种相关的系统性病变。治疗或观察后，除2例MALT淋巴瘤患者外，几乎所有患者的病变均有所改善或稳定。
表现为泪腺不对称肿大的TED患者需要进一步评估。应考虑对泪腺进行活检并进行全面的全身检查，因为这可能有助于发现其他病理实体，尤其是恶性肿瘤，从而有助于挽救患者生命。
