Orbital, Plastic and Lacrimal Clinic, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia.
Department of Anatomical Pathology, St Vincent's Hospital, Fitzroy, Australia.
Orbit. 2022 Jun;41(3):378-381. doi: 10.1080/01676830.2020.1867194. Epub 2021 Jan 6.
Lacrimal gland pleomorphic adenomas (LGPA) are benign mixed tumors. Diagnosis is based on clinical and radiological findings which usually prompts complete excision of the lesion to minimise recurrence and a cumulative risk of malignant transformation. Necrosis in pleomorphic adenoma has been rarely reported in salivary gland PA, either spontaneously or due to iatrogenic interventions. Necrosis is suggestive of a malignant process and makes interpretation of histology specimens difficult. A 23 year old woman, while awaiting biopsy for a mass in the left lacrimal gland, which had been symptomatic for only several months, presented with acute pain and swelling of the left lateral lid. An incisional biopsy showed an inflamed lacrimal gland with focal necrosis and atypia of adjacent cytology and gland architecture. Subsequent excisional biopsy confirmed an LGPA with some inflammation but no necrosis. Necrosis may occur as an atypical presentation in LGPA.
泪腺多形性腺瘤（LGPA）是良性混合瘤。诊断基于临床和影像学发现，通常建议完整切除病变以最大程度减少复发和累积恶变风险。在唾液腺多形性腺瘤中，无论是自发性还是由于医源性干预，都很少报道有肿瘤坏死。坏死提示恶性过程，使组织学标本的解释变得困难。一名 23 岁女性，因左眼泪腺肿块等待活检（仅出现数月症状），出现左眼外侧肿胀和急性疼痛。切开活检显示炎症性泪腺，伴有局灶性坏死和邻近细胞学和腺体结构的异型性。随后的切除活检证实为 LGPA，伴有一些炎症，但无坏死。LGPA 也可能以非典型表现出现坏死。
