论文部分内容阅读
目的探讨鼻泪管恶性肿瘤的临床病理特征及鉴别诊断。方法观察2例鼻泪管恶性肿瘤的临床表现、影像学特点、组织病理学特征和免疫组化,并复习相关文献。结果 2例肿瘤均累及鼻泪管及周围组织,以溢泪等功能障碍为首发症状。例1镜下肿瘤细胞以小淋巴细胞样细胞为主,弥漫分布,其间散在分布中等大小肿瘤细胞,核仁明显。CD20弥漫(+)、Ki-67阳性指数70%。病理诊断:弥漫性大B细胞淋巴瘤。例2镜下肿瘤细胞巢状分布,部分细胞巢中央可见显著坏死,部分瘤细胞可见透明胞质。EMA、AR(+),Ki-67阳性指数50%。病理诊断:高分化皮脂腺癌。结论鼻泪管肿瘤极罕见,由于特殊的解剖特点,肿瘤难以完整切除,复发可能性很大,预后不佳。
Objective To investigate the clinicopathological features and differential diagnosis of nasolacrimal duct malignant tumor. Methods The clinical manifestations, imaging features, histopathological features and immunohistochemistry of 2 cases of nasolacrimal duct malignant tumor were observed and the related literatures were reviewed. Results Both of the two tumors involved the nasolacrimal duct and the surrounding tissues. The first symptom was the dysfunction of overflowing tears and so on. Example 1 microscopic tumor cells to small lymphocyte-like cells, diffuse distribution, interspersed during the distribution of medium-sized tumor cells, nucleoli obvious. CD20 diffuse (+), Ki-67 positive index of 70%. Pathological diagnosis: diffuse large B cell lymphoma. Example 2 Microscopic distribution of tumor cells in nests, visible necrosis in the center of some cell nests, and some tumor cells showed clear cytoplasm. EMA, AR (+), Ki-67 positive index of 50%. Pathological diagnosis: highly differentiated sebaceous gland cancer. Conclusion Nasolacrimal duct tumors are extremely rare. Due to the special anatomical features, it is difficult to completely remove the tumor. The possibility of recurrence is very high and the prognosis is poor.