Clinical Characteristics and Imaging features of Primary Orbital Lymphoma
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摘要: 目的:分析原发性眼部淋巴瘤的临床及影像特征,提高对该病的认识及早期诊断的能力。方法:回顾性收集2015年1月至2022年5月间符合入组条件的原发性眼部淋巴瘤病例共82例,分析其临床特征、病理亚型以及影像表现。结果:原发性眼部淋巴瘤临床症状以眼睑肿胀(52/82,63.4%)与眼球突出(43/82,52.4%)最常见,病理类型主要为B细胞淋巴瘤,尤其以黏膜相关淋巴组织淋巴瘤多见(60/82,73.2%),病变多单眼受累(59/82,72.0%),结膜为最好发部位(29/82,35.4%),其次为眼睑(16/82,19.5%)与肌锥区(11/82,13.4%);66例行MRI检查,61例行CT检查。MRI多表现为T1WI等信号(60/66,90.9%),T2WI高信号(51/66,77.3%),MRI与CT均以肿瘤明显强化最多见,分别占74.2%与 70.5%,CT另见2例邻近骨质破坏。结论:原发性眼部淋巴瘤多为B细胞淋巴瘤,以黏膜相关淋巴组织淋巴瘤最多见,多单眼受累,结膜为常见好发部位,MRI/CT多呈均匀明显强化。Abstract: Objective: To analyze the clinical characteristics and imaging features of primary orbital lymphoma in order to improve early diagnosis of the disease. Methods: Eighty-two patients were recruited from January 2015 to May 2022 who were diagnosed with orbital lymphomas via histopathology. The data on clinical characteristics, pathological subtypes, and imaging features for those patients were analyzed including symptoms, uni- or bilateral eye involvement, single or multiple lesions, tumor location, growth pattern, MRI signal intensity and MRI/CT enhancement patterns. Results: Eyelid swelling (52/82, 63.4%) and proptosis (43/82, 52.4%) were the two most common symptoms for primary orbital lymphomas, whose pathologic subtypes were mainly B-cell lymphomas, especially mucosa-associated lymphoid tissue lymphoma (60/82, 73.2%), and 59 cases (59/82, 72.0%) had unilateral eye involvement. Conjunctiva was the most common location (29/82, 35.4%), followed by eyelid (16/82, 19.5%) and muscle cone (11/82, 13.4%). Of the 66 cases who underwent MRI examinations, 60 showed iso-intensity on T1WI (90.9%), and 51 showed hyper-intensity on T2WI (77.3%). The tumors showed obvious enhancement on contrast-enhanced MRI or CT with 74.2% and 70.5%, respectively. Two other cases showed adjacent bone involvement on CT. Conclusion: B-cell lymphoma, especially mucosa-associated lymphoid tissue lymphoma was the most common primary orbital lymphoma subtype. The tumors mostly had unilateral eye involvement and the conjunctiva was the most common location. The typical imaging features were obvious enhancement on contrast-enhanced MRI or CT that would facilitate tumor diagnosis and treatment decision.
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Key words:
- imaging diagnosis /
- lymphoma /
- orbital /
- primary
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表 1 原发性眼部淋巴瘤的临床与影像征象分析
Table 1. Analysis of the clinical characteristics and imaging features of primary orbital lymphoma
观察指标 例数 观察指标 例数 年龄/岁,中位数(四分位数) 53(32,73) 生长方式(n=82),例数(%) 性别(n=82),例数(%) 局限性 26(31.7) 男 49(59.8) 浸润性 56(68.3) 女 33(40.2) MRI-T1 WI信号(n=66),例数(%) 临床症状(n=82),例数(%) 等 60(90.9) 眼睑肿胀 52(63.4) 低 6(9.1) 眼球突出 43(52.4) MRI-T2 WI信号(n=66),例数(%) 眼睛疼痛 34(41.5) 高 51(77.3) 结膜炎 31(37.8) 等 15(22.7) 眼球运动障碍 29(35.4) 低 0(0) 自觉触及肿物 25(30.5) MRI强化程度(n=66),例数(%) 视力或视野改变 22(26.8) 明显 49(74.2) 眼睑下垂 16(19.5) 中等 13(19.7) 眼肌麻痹 13(15.9) 轻度 4(6.1) 病理亚型(n=82),例数(%) MRI强化方式(n=66),例数(%) 粘膜相关淋巴组织淋巴瘤 60(73.2) 均匀 59(89.4) 弥漫大B细胞淋巴瘤 13(15.9) 不均匀 7(10.6) 套细胞淋巴瘤 3(3.7) CT强化特征(n=61),例数(%) 滤泡性淋巴瘤 2(2.4) 明显强化 43(70.5) 淋巴浆细胞淋巴瘤 1(1.2) 中等强化 13(21.3) T细胞淋巴瘤 3(3.7) 轻度强化 5(8.2) 单眼或双眼受累(n=82),例数(%) CT强化方式(n=61),例数(%) 单眼 59(72.0) 均匀 51(83.6) 双眼 23(28.0) 不均匀 10(16.4) 单灶或多灶(n=82),例数(%) CT骨质破坏(n=61),例数(%) 单灶 47(57.3) 有 2(3.3) 多灶 35(42.7) 无 59(96.7) 肿瘤主体位置(n=82),例数(%) 治疗方法(n=82),例数(%) 结膜区 29(35.4) 手术 9(11.0) 眼睑区 16(19.5) 放疗 14(17.1) 肌锥区 11(13.4) 化疗 7(8.5) 肌锥内区 10(12.2) 手术+放疗 24(29.3) 泪腺区 9(11.0) 手术+化疗 17(20.7) 肌锥外区 5(6.1) 手术+放化疗 8(9.8) 眼球 2(2.4) 放疗+化疗 3(3.7) -
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