摘要
目的探讨眼眶嗜酸性粒细胞增生性淋巴肉芽肿（Kimura病）的临床病理学特点。方法回顾性系列病例研究。对天津市眼科医院病理科从1976年至2008年间诊断的9例Kimura病患者的临床和病理学特点进行总结，分析CD20、CD79a、CD3、CD45Ro、CD34、Ki67及IgE等抗体免疫组织化学染色特点。结果9例中，男性7例，女性2例，发病年龄13—62岁，年龄中位数为25岁；7例为单眼眶内病变，2例为双眼眶内病变。病变均发生在眼眶上方或颞上方，多数病例侵及眶内深部组织，6例累及泪腺，5例累及外直肌。其中1例伴有左侧颌下3个肿大的淋巴结和双侧肘部各1个皮下肿块。临床主要表现为眼睑红肿、眼球突出和眶内肿物，发病时间为6个月一15年。3例患者外周血检查显示嗜酸性粒细胞数量增高（11％－14％）。病理学特点为大量分化成熟的淋巴细胞增殖，其间有大小不一的淋巴滤泡、大量嗜酸性粒细胞浸润和增生的毛细血管。免疫组织化学染色显示淋巴滤泡内的细胞表达B细胞抗原，滤泡间的淋巴细胞多数表达T细胞抗原。结论Kimura病是一种很少见的眶内淋巴组织增生病变，伴有大量嗜酸性粒细胞浸润和毛细血管增生，好发于眼眶外上方，容易累及泪腺和外直肌。
Objective To improve the knowledge of the clinicopathologic features of eosinophilic hyperplastic lymphogranuloma （Kimura disease） in the orbit. Methods It was a retrospective case series study. The clinical and pathological characteristic of 9 cases of Kimura disease from the pathology department of Tianjin Eye Hospital were reviewed, immunohistochemical staining was performed, including for CD20, D79a, CD3, CIM5Ro, CD34, Ki67 and IgE. Results In the 9 cases, 7 cases were male, 2 cases were female; the age of onset were from 13 to 62 years, medium age was 25 years; 7 cases were simple, 2 case were bilateral orbit. These lesions occurred in the superior or superotemporal quadrant of the orbit and the majority of cases extended into deep orbital tissues, 6 cases involved the lacrimal gland, 5 case involved the lateral rectus muscle. The clinical features mainly included lid swelling, eye redness, proptosis and palpable mass, and the disease course ranged from 6 months to 15 years. 3 lymph node enlargements in the submandibular regions and 1 subcutaneous nodule on the bilateral elbow were found in one case. The documentation of peripheral-blood eosinophilia （11% - 14% ） was found in 3 cases. The pathological characteristics of Kimura disease were lymphoid tissue hyperplasia with prominent lymphoid follicles, conspicuous eosinophils infiltration and capillary proliferation. Immunohistochemical study in our cases revealed B cells in lymphoid follicles and mostly T cells in the interfollicular regions. Conclusion Kimura disease of orbit is an uncommon lymphoid hyperplasia with prominent eosinophils infiltration and capillary vessels, which commonly occur superotemporal quadrant of the orbit, easy to involve lacrimal gland and lateral rectus muscle.
出处
《中华眼科杂志》
CAS
CSCD
北大核心
2011年第5期427-430,共4页
Chinese Journal of Ophthalmology
