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泪腺Castleman病的临床分析

Clinical Analysis of Castleman's Disease of the Lacrimal Gland.

作者信息

Li Dongping, Tang Dongrun, Sun Fengyuan

机构信息

Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China.

Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Tianjin 300384, China.

出版信息

J Ophthalmol. 2020 Nov 23;2020:3718305. doi: 10.1155/2020/3718305. eCollection 2020.

Abstract

OBJECTIVE

To explore the clinical manifestations, imaging characteristics, and pathological characteristics of Castleman's disease of the lacrimal gland, enhance the knowledge of the disease, and improve the level of its diagnosis and treatment.

METHODS

In the retrospective study, the data of 5 patients diagnosed with Castleman's disease of the lacrimal gland in Tianjin Medical University Eye Hospital from 2014 to 2018 were analyzed, and the relevant literature was reviewed.

RESULTS

All the 5 patients were confirmed by pathological examination. Clinical manifestations were characterized by mass occupying lesions in the lacrimal gland area, without obvious pain, accompanied by eyelid swelling and ptosis, as well as space-occupying symptoms. Imaging examination showed that there was a soft tissue mass in the enlarged lacrimal gland area, and the mass was rich in blood flows while showing no obvious specificity, which could invade the surrounding muscles. All patients underwent surgical resection. Pathological results showed that 1 case was of the hyaline-vascular type, 3 cases were of the plasma cell type, and 1 case showed malignant transformation to plasma cell tumor.

CONCLUSION

Castleman's disease of the lacrimal gland is a rare orbital lymphoproliferative disease lacking specificity in clinical manifestations and imaging examination. As there are difficulties in differentiating the disease from orbital inflammatory pseudotumor and orbital lymphoma, its diagnosis still depends on pathological examination. The disease is mainly treated with surgical resection, and the pathological type is determined postoperatively.

摘要

目的

探讨泪腺Castleman病的临床表现、影像学特征及病理特征,提高对该疾病的认识,提升其诊断与治疗水平。

方法

采用回顾性研究方法,分析2014年至2018年在天津医科大学眼科医院确诊为泪腺Castleman病的5例患者资料,并复习相关文献。

结果

5例患者均经病理检查确诊。临床表现以泪腺区占位性病变为主,无明显疼痛,伴有眼睑肿胀及上睑下垂等占位症状。影像学检查显示泪腺区增大,有软组织肿块,肿块血流丰富但无明显特异性,可侵犯周围肌肉。所有患者均行手术切除。病理结果显示,透明血管型1例,浆细胞型3例,1例发生恶变转化为浆细胞瘤。

结论

泪腺Castleman病是一种少见的眼眶淋巴增殖性疾病,临床表现及影像学检查缺乏特异性,与眼眶炎性假瘤及眼眶淋巴瘤鉴别困难,诊断仍依赖病理检查。该病主要采用手术切除治疗,术后确定病理类型。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08b0/7803145/29791be6594a/joph2020-3718305.001.jpg

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