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原发性眼部淋巴瘤的临床与影像特征分析
引用本文:朱建波,李彬,张红梅,王宁利.原发性眼部淋巴瘤的临床与影像特征分析[J].CT理论与应用研究,2023,32(2):223-230.
作者姓名:朱建波  李彬  张红梅  王宁利
作者单位:1.首都医科大学附属北京同仁医院, 北京同仁眼科中心/北京市眼科和视觉科学重点实验室, 北京100730
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。 

关 键 词:影像诊断    淋巴瘤    眼部    原发性
收稿时间:2022-12-06

Clinical Characteristics and Imaging features of Primary Orbital Lymphoma
Institution:1.Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University/Key Laboratory of Ophthalmology and Visual Science, Beijing 100730, China2.Department of Diagnostic Radiology, Cancer Hospital/Chinese Academy of Medical Sciences, National Cancer Center, Beijing 100021, China
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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