雙側原發性淚囊淋巴瘤

Bilateral Primary Lacrimal Sac Lymphoma

蔡凱喻(Kai-Yu Tsai) ； 王仁鵬(Jen-Peng Wang)

《台灣耳鼻喉頭頸外科雜誌》 48卷4期 (2013/12) Pp. 315-318

https://doi.org/10.6286/2013.48.4.315

摘要

原發性淚囊淋巴瘤相當的罕見，多以單側為主，雙側非常少見。本例病患為一48歲女性，在臨床上表現為雙側溢淚2年，經眼科通條擴張術之後，症狀並未緩解，經本科於2006年4月21日施行內視鏡淚囊鼻造口及人工鼻淚管置放手術，術中發現腫瘤併腫瘤全切除手術，病理報告為低惡性度B細胞淋巴瘤。病患術後接受骨髓穿刺檢查和血液檢查，結果正常。術後追蹤至今5年，臨床上內視鏡及核磁共振檢查均無復發情形。

關鍵字

原發性淋巴瘤(primary lymphoma) ； 淚囊(lacrimal sac) ； 雙側(bilateral) ； 內視鏡淚囊鼻造口及人工鼻淚管置放手術(endonasal dacrocystorhinostomy)

並列摘要

Primary lymphoma of lacrimal sac is very rare. Unilateral involvement is often in most case. In this case we report on a 48-year-old female presented with bilateral primary lymphoma of lacrimal sac. She was presented with bilateral eyes epiphora for 2 years. Although several irrigation in order to treatment her complaint did not recover, she was referred to our department for endoscopic assisted endonasal dacrocystorhinostomy. She was received left side endonasal dacrocystorhinostomy with CIS tube insertion in our ward on 2006/04, and received right side operation 1 month later. Lacrimal sac tumor was noted and excised during the operation. Microscopically the section of tumor showed low-grade B cell lymphoma (small blue round cell tumor, CD20+/NSE-/CK-, suspect low-grade B cell lymphoma), positive for common leukocyte antigen and CD20, while negative for CD3, NSE, O13, CK, CD34, caldesmon, and P63. The systemic evaluation included complete blood count, biochemical test were in normal range. Bone marrow biopsy, abdomen and pelvic CT showed negative finding. All of the finding indicated that the patient had Primary lymphoma of lacrimal sac. Radiotherapy was suggested but it was refused by patient herself. Although radiotherapy was considered the stander treatment for indolent orbital lymphoma, the patient was only treated with surgery and she was well remained to remission during a follow up of 5 year period. The disease was free and no evidence of recurrence in clinical symptoms and signs, endoscopy examination and MRI in the following 5 years after the operation.