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眼眶非霍奇金恶性淋巴瘤(NHL)临床少见,现将我院诊治的5例报告如下: 例1 患者,男,10岁,左眼球突出伴视力下降20多天。体检:贫血、消瘦外观,左眼视力0.4,眼球向前下突出、活动受限,眼眶外上方触及一约4cm×5cm×3cm肿物,质中等、边界不清、活动度好、压痛明显,球结膜水肿,眼底呈贫血性改变。B超示左眼眶有一肿物,肝脾肿大。切除眼眶肿物,其病理诊断为NHL(淋巴母细胞性)。骨髓穿刺发现淋巴瘤骨髓浸润:患者拒绝进一步治疗,2个月后死亡。 例2 患者,男,8岁,左上睑肿物进行性增大15天。体检:左眼视力0.8,左上睑肿胀,睁眼困难,眼球向内、下突出、外转受限,眼眶颞侧探及一大小约2cm×1.5cm肿物,质较硬、境界不清、活动度差、压痛明显。CT示左眼眶占位性病变,累及眶外侧壁并向颅内及颞凹延伸。切除肿物,其病理诊断为左眼眶肌间NHL浸润眶骨壁。术后给予COP方案化疗,现门诊随诊。 例3 患者男,50岁,双眼睑肿物半年。体检:双眼视力1.0,右下睑肿胀,触及一大小约1cm×1cm×1cm肿物,境界清楚、质地中等、无压痛,左上睑下垂、眼裂3mm,触及一大小约2cm×1cm×1cm肿物。切除肿物其病理诊断为弥漫型NHL(混合细胞性),术后眼睑下垂改善。术后给予COPD方案化疗,现门诊随诊。
Orbital non-Hodgkin’s lymphoma (NHL) clinical rare, now our hospital diagnosis and treatment of 5 cases are reported as follows: Example 1 patients, male, 10 years old, left eye protrusion with decreased visual acuity more than 20 days. Physical examination: anemia, emaciated appearance, visual acuity of left eye 0.4, prominence of the eyeball forward, limited activity, touching the top of the orbital about 4cm × 5cm × 3cm mass, medium quality, unclear boundary, good activity, tenderness, Bulbar conjunctival edema, fundus anemia was changed. B ultrasound showed a tumor of the left orbit, hepatosplenomegaly. Resection of orbital tumor, the pathological diagnosis of NHL (lymphoblastic). Bone marrow puncture found lymphoma bone marrow infiltration: The patient refused to further treatment, died after 2 months. Example 2 patients, male, 8 years old, left upper lid tumor progressive increase 15 days. Physical examination: visual acuity left eye 0.8, left upper eyelid swelling, difficulty in eye opening, eyeball inward, under prominent, outside the transfer limit, orbital temporal exploration and a size of about 2cm × 1.5cm tumor, the quality of hard, unclear, Poor activity, tenderness significantly. CT showed left orbital space-occupying lesions involving the lateral orbital wall and extended to the intracranial and temporal recesses. Removal of the tumor, the pathological diagnosis of left orbital NHL infiltration of the orbital wall. Postoperative COP regimen chemotherapy, are outpatient follow-up. Example 3 patients male, 50 years old, double eyelid tumor for six months. Physical examination: binocular visual acuity 1.0, right lower lid swelling, touching a size of about 1cm × 1cm × 1cm tumor, clear the state, medium texture, no tenderness, left upper eyelid ptosis, eye crack 3mm, touching a size of about 2cm × 1cm × 1cm swollen Things. Removal of the pathological diagnosis of diffuse NHL (mixed cell), postoperative eyelid ptosis improved. Postoperative COPD chemotherapy, now out-patient follow-up.