中国口腔颌面外科杂志

中国口腔颌面外科杂志 ›› 2020, Vol. 18 ›› Issue (5): 451-456.doi: 10.19438/j.cjoms.2020.05.014

• 临床总结 • 上一篇    下一篇

15例腮腺淋巴腺瘤临床病理分析

刘胜文1, 杨雯君1, 王丽珍2, 袁方3   

  1. 1.上海交通大学医学院附属第九人民医院·口腔医学院 口腔颌面-头颈肿瘤科,2.口腔病理科, 国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室, 上海市口腔医学研究所,上海 200011;
    3.上海交通大学医学院附属第九人民医院 超声诊断科,上海 200011
  • 收稿日期:2019-09-11 修回日期:2020-04-03 出版日期:2020-09-20 发布日期:2020-10-28
  • 通讯作者: 袁方,E-mail：yuanfang55@126.com
  • 作者简介:刘胜文（1986-）,男,硕士,mail：wubenzhimu17@163.com
  • 基金资助:
    上海九院基础研究助推计划资助（JYZZ115）; 上海市科学技术委员会科研项目（16ZR1418800）

Clinicopathologic studies of lymphadenoma of the parotid gland in 15 cases

LIU Sheng-wen1, YANG Wen-jun1, WANG Li-zhen2, YUAN Fang3   

  1. 1. Department of Oromaxillofacial Head and Neck Oncology, 2. Department of Oral Pathology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology. Shanghai 200011;
    3. Department of Ultrasound Diagnosis, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011, China
  • Received:2019-09-11 Revised:2020-04-03 Online:2020-09-20 Published:2020-10-28

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摘要： 目的：分析腮腺淋巴腺瘤的临床病理表现、治疗方法及预后。方法：回顾分析1993年1月—2017年7月上海交通大学医学院附属第九人民医院收治的15例腮腺淋巴腺瘤患者的临床资料,总结其临床病理特征、手术和预后情况。采用SAS 9.0软件包对数据进行统计学分析。结果：15例患者中,男9例,女6例;发病年龄10~75岁,中位年龄50.5岁,60岁以上老年人多见（53.3%）。病程长短不一,最长达20余年,最短仅11 d;肿瘤好发于腮腺下极,直径均小于3 cm,无疼痛及面瘫症状,其中1例为多发肿瘤灶。14例为原发, 1例为外院腮腺肿瘤术后第二原发;皮脂型4例（1例癌变）,非皮脂型11例;免疫组织化学染色检测S-100、SMA、Vim、Des、Calp、Kp-1表达阴性,CK-p、CK8、CKH、CK19、EMA、P63表达阳性。13例患者均行保留面神经的腮腺浅叶或区域切除术,2例行保留面神经的腮腺全叶切除术。截止2019年6月,术后随访14例患者中,13例为良性肿瘤,1例为低度恶性肿瘤,均生存,无复发,面神经功能正常。随访最长时间159个月,最短49个月,中位时间111.5个月。结论：腮腺淋巴腺瘤是一种多发于老年人的良性肿瘤,病程长短不一,好发于腮腺下极,可呈多灶性,癌变少见,单纯手术切除预后佳。

关键词: 淋巴腺瘤, 腮腺, 临床病理

Abstract: PURPOSE: To analysis the clinicaopathological prognostic factors of lymphadenoma in parotid gland. METHODS: The clinicopathological records of 15 patients with diagnosis of parotid gland lymphadenoma treated at Shanghai Ninth People Hospital since 1993/1 to 2017/7 were retrospectively reviewed. Immunohistochemical test was used to detect the expression of S-100, SMA, Vim, Des, Calp, Kp-1, CKp, CK8, CKH, CK19, EMA and P63 in parotid gland lymphadenoma, the relationship with gender, age, size, location and pathological features was analyzed using SAS 9.0 software package. RESULTS: The median age of the patients was 50.5 years old, and the tumor mainly occured in patients over 60 years old. Males were obviously much more prone to it than females. The course of lymphadenoma was different, from 11 days for the shortest to more than twenty years for the longest. All patients had no pain or facial paralysis during the course of disease. Most of the neoplasm were located in the lower lobe of the parotid gland, and all these tumors were smaller than 3 cm in diameter. One of these patients had multiple masses in the parotid gland. Of all 15 patients, there were 11 non-sebaceous lymphadenoma (NSL) and 4 sebaceous lymphadenoma(SL), including 1 low-grade malignancy case. S-100, SMA, Vim, Des, Calp and Kp-1 were negatively expressed in the tumor tissues, while expression of CKp, CK8, CKH, CK19, EMA and p63 was positive. Thirteen patients underwent superficial parotidectomy or regional resection with preservation of facial nerve, while 2 patients underwent total parotidectomy with preservation of facial nerve. Fourteen patients were followed up successfully, including 13 with benign tumor and 1 with low-grade malignancy. Until to 2019/6, the median follow-up period was 111.5 months, with 159 months for the longest and 49 months for the shortest. All patients survived without recurrence or facial paralysis. CONCLUSIONS： Parotid gland lymphadenoma is a kind of benign tumor which mainly occurs in patients over 60 years old; the course of lymphadenoma is different and the tumor is mainly located in the lower lobe of the parotid gland, there may be multiple masses and can be malignancy. For parotid gland lymphadenoma, the radical resection alone is enough and the prognosis is good.

Key words: Lymphadenoma, Parotid gland, Clinicaopathological factor

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