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目的探讨[附属器包括[睑、结膜、[眶和泪腺等部位MALT淋巴瘤的临床诊断要点,影像学检查特征与治疗和预后。方法回顾性分析1994年至2005年在第二军医大学长征医院[科确诊的45例[附属器MALT淋巴瘤的临床表现、影像学检查、手术治疗及病理结果与预后情况。结果[附属器MALT淋巴瘤23例发生于[眶,10例发生于[睑,8例发生于泪腺,4例发生于结膜。B超、CT、MRI均能进行定位、定性诊断,B超能较好地显示病变内部结构和形态;CT对眶骨结构和肿瘤侵犯范围与周围组织的关系显示良好,具有定性诊断价值;MRI对软组织的分辨力强,成像参数根据不同的信号强度可提示病变的内部结构。45例均行手术治疗;其中22例辅以放疗,10例结合化疗。42例随访4～135个月,1例于手术切除后25个月转移至肺死亡,其余均存活。结论[附属器MALT淋巴瘤好发于[眶上方及[睑,影像学检查对MALT淋巴瘤的诊断及鉴别诊断有帮助。手术切除肿瘤,结合病理诊断和临床分期判断能提示较准确的病情估计,病变可长期局限,预后较好,一般不会出现全身转移和向弥漫性大细胞高度恶性淋巴瘤转化。
Objectives To investigate the clinical diagnosis of MALT lymphoma, including eyelid, conjunctiva, orbital and lacrimal gland, and its imaging features, treatment and prognosis. Methods The clinical manifestations, imaging findings, surgical treatment and pathological findings and prognosis of adnexal MALT lymphoma from 1994 to 2005 in Changzheng Hospital of Second Military Medical University were retrospectively analyzed. Results [There were 23 appendage MALT lymphomas in [orbital, 10 in eyelid, 8 in lacrimal gland and 4 in conjunctiva. B ultrasound, CT, MRI were able to locate, qualitative diagnosis, B ultrasound can better display the internal structure and morphology of the lesion; CT orbital bone structure and tumor invasion of the surrounding tissue showed good relationship with the value of qualitative diagnosis; MRI Strong resolution of the soft tissue, imaging parameters according to the different signal strength can be prompted to lesion internal structure. Forty-five patients underwent surgery; 22 patients received radiotherapy and 10 patients received chemotherapy. Forty-two patients were followed up for 4 to 135 months. One patient died of pulmonary metastasis 25 months after surgical resection, and the rest survived. Conclusions [The appendage MALT lymphoma occurs predominantly [supraorbital and [eyelid, imaging diagnosis of MALT lymphoma diagnosis and differential diagnosis helpful. Surgical resection of the tumor, combined with pathological diagnosis and clinical stage to judge can prompt a more accurate assessment of the disease, the disease can be long-term limitations, the prognosis is good, generally does not appear systemic metastasis and diffuse large malignant lymphoma into large cell lymphoma.