Overview: eyes benign lymphoepithelial lesion (benign lymphoepithelial lesion), also known as Mikulicz disease, lacrimal gland and salivary gland tissue to diffuse infiltration of lymphocytes, while lacrimal gland ductal myoepithelial hyperplasia, lesions of lymphoid and epithelial cells as a source of benign lesions.[Cause]
(B) the pathogenesis
may be an autoimmune associated with idiopathic inflammatory. Specific disease mechanism is unclear.[Sign]
The disease can occur at any age, with bilateral common (Figure 1). history of gradual enlargement of the lacrimal gland, pain, swelling of upper eyelid skin, eye on the outside before the palpable mass, proptosis (Figure 3). middle-aged women, lacrimal gland enlargement, dry mouth and also have to consider bilateral lacrimal gland enlargement of salivary gland benign lymphoepithelial lesion. Gradual enlargement of the lacrimal gland, soft and flexible, no tenderness, swelling of upper eyelid skin to the outside was not associated with red eye pain. lacrimal gland enlargement of the ipsilateral exophthalmos can cause the nose to the bottom of the shift, turn on the outside of the affected eye is limited. Part of the lacrimal gland tumor patients may be due to changes in refractive eye pressure caused by decreased vision. General vice lacrimal gland is not involved, the patient may have nothing to do eye, eye pain, foreign body sensation and other symptoms. At the same time as bilateral salivary gland involvement, the patient may also have bilateral salivary gland enlargement, accompanied by dry mouth, dry throat, discomfort and other symptoms.
unilateral lacrimal gland enlargement, with bilateral salivary gland enlargement, dry eye, and no other systemic disease, benign lymphoepithelial lesion should be suspected of may be. biopsy when necessary, desirable, see the infiltration of lymphocytes in the lacrimal gland, also see myoepithelial island formation can be diagnosed with this disease. CT scan shows the temporal orbit above the soft tissue mass, density, clear boundary. orbital bone without damage.[Aftertreat]
benign lymphoepithelial lesion should be how to prevent?
currently no related content description.[Treat]
disease is an idiopathic inflammatory, and autoimmune related, so you should use leather hormone therapy. Mainly lymphocytic infiltration within the lesion can be localized radiation therapy. mass may also consider a more limited surgical removal.
(b) the prognosis
benign lymphoepithelial lesion should be how?
1. circulating immune complexes (CIC).
2.IgM, IgG, IgA.
4.PCR with IgH gene rearrangement PCR analysis confirmed the polyclonal lymphocytes. L26-positive B-lymphocytes, UCHL-positive T lymphocytes, indicating that lymphatic lesions by the B, t lymphocytes form.
5. histopathological examination benign lymphoepithelial cause of the limitations of capsule by the lacrimal gland, lacrimal gland inflammation occurs mainly in the inside, there are more matrix lacrimal gland lymphocytic infiltration, catheter increase the formation of the so-called myoepithelial myoepithelial island. The island seems to float in a sea of lymphocytes (Figure 4). lacrimal gland fibrosis rarely real, real obvious within the lymphoid follicles, which is the formation of inflammatory pseudotumor of the lacrimal gland difference. In inflammatory pseudotumor in a variety of inflammatory cell infiltration, lymphoid follicles apparent, the real significant fibrosis. immunohistochemical staining, lymphocytes κ, λ staining, indicating that the two-light chain expression. keratin staining myoepithelial islands, epithelial cells of the island, desmin staining confirmed that these cells have the characteristics of muscle fibers. myoepithelial islands are not benign lymphoepithelial tumor of the unique pathological features, 30% to 50% of Sjögren's syndrome cases, due to the remnants of the ductal myoepithelial hyperplasia myoepithelial island formation. Found in the lacrimal gland biopsy in cases of myoepithelial islands, combined with clinical manifestations, about 25% of patients with Sjögren may levy, and the remaining patients with benign lymphoepithelial lesion.
6.B ultrasound and mri can find the top orbital mass, mostly bilateral; bilateral size and more similar, but also of different sizes; mass shapes, and more elongated flat (Figure 5), while structured, can be surrounded by the eye, significantly enhanced mass; lesions near the lateral rectus muscle can be enlarged, thickened muscle bundle can be extended to The only point, should be combined with clinical dry eyes, dry eye symptoms diagnosis.
benign lymphoepithelial lesion and the diseases easily confused?
1. inflammatory pseudotumor of the lacrimal gland swelling caused by inflammatory pseudotumor, but not salivary gland enlargement. histopathology of inflammatory pseudotumor is no myoepithelial island to a variety of inflammatory cell infiltration and fibrosis of its features. These pathological changes with benign lymphoepithelial lesion different. lymphoma can also make the lacrimal gland enlargement, but the tumor growth is not only confined to the capsule, the tumor may invade the orbital fat, a large number of lymphocytes within the tumor tissue, but no myoepithelial islands.
2. Castleman disease castleman's disease can cause painless swelling of the lacrimal gland, salivary gland enlargement, hepatosplenomegaly. The pathological features of lymphocytic infiltration, lymphoid follicles, the germinal center may have transparent blood vessels, but no myoepithelial islands.[Disease]
mania alternating with drowsiness-related diseases
more other symptoms
"frozen" phenomenon "three fears" (water, sound, light 21 - hydroxylase deficiency igm antibodies sm accumulation increased belching physical scars, daytime sleepiness, nighttime insomnia, leukopenia, leukocytosis, signs of leukemic cell infiltration in sepsis to maintain sleep disorder galactosemia lost hold of a passive position overeating addiction rage stolen or hypochondriacal paranoia delusions
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