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Abstract：
OBJECTIVE: To determine the clinical characteristics, pathological types, tumor markers, treatments, and outcomes of Chinese patients with primary lacrimal sac lymphoma.
METHODS: This case-based retrospective study analyzed 15 Chinese patients with primary lacrimal sac lymphoma. The clinical data collected included gender, age at diagnosis, symptoms, imaging examination results, pathologic diagnosis, pathogen identification, tumor markers, treatments, follow-up, and prognosis. Descriptive statistics were used to characterize the patients. Progression-free survival (PFS) was defined as the time from surgery to the last follow-up, first record of tumor recurrence, or death.
RESULTS: There were 7 males and 8 females with unilateral primary lacrimal sac lymphoma in the left eye (n=6) or right eye (n=9). The initial symptom in 13 patients was epiphora, and 2 patients had redness and swelling in the lacrimal sac area. All patients ultimately developed epiphora, and 12 had masses in the lacrimal sac area. Analysis of preoperative plasma tumor markers indicated 14 patients had elevated homocysteine, 9 had elevated β2-microglobulin, and 2 had elevated lactate dehydrogenase (LDH); 2 patients had elevations of all three markers, and 1 patient had no elevation of any marker. All patients underwent surgical resection and 12 patients received postoperative chemotherapy. The pathological types were DLBCL (n=8), MALT lymphoma (n=5), and NK/T-cell lymphoma, nasal type (n=2). The mean follow-up time was 25.8mo (range: 4-41) and 2 patients died. Seven patients who underwent mass excision combined with dacryocystorhinostomy (DCR) had no postoperative epiphora. Eight patients who only underwent mass excision had varying degrees of postoperative epiphora. Preoperative LDH elevation and NK/T-cell lymphoma, nasal type were associated with poor prognoses.
CONCLUSIONS: Early diagnosis and treatment can lead to a good prognosis for most patients with primary lacrimal sac lymphoma. Mass resection combined with DCR can reduce the occurrence of post-surgical epiphora. The pathology type and tumor marker status are associated with prognosis.
METHODS: This case-based retrospective study analyzed 15 Chinese patients with primary lacrimal sac lymphoma. The clinical data collected included gender, age at diagnosis, symptoms, imaging examination results, pathologic diagnosis, pathogen identification, tumor markers, treatments, follow-up, and prognosis. Descriptive statistics were used to characterize the patients. Progression-free survival (PFS) was defined as the time from surgery to the last follow-up, first record of tumor recurrence, or death.
RESULTS: There were 7 males and 8 females with unilateral primary lacrimal sac lymphoma in the left eye (n=6) or right eye (n=9). The initial symptom in 13 patients was epiphora, and 2 patients had redness and swelling in the lacrimal sac area. All patients ultimately developed epiphora, and 12 had masses in the lacrimal sac area. Analysis of preoperative plasma tumor markers indicated 14 patients had elevated homocysteine, 9 had elevated β2-microglobulin, and 2 had elevated lactate dehydrogenase (LDH); 2 patients had elevations of all three markers, and 1 patient had no elevation of any marker. All patients underwent surgical resection and 12 patients received postoperative chemotherapy. The pathological types were DLBCL (n=8), MALT lymphoma (n=5), and NK/T-cell lymphoma, nasal type (n=2). The mean follow-up time was 25.8mo (range: 4-41) and 2 patients died. Seven patients who underwent mass excision combined with dacryocystorhinostomy (DCR) had no postoperative epiphora. Eight patients who only underwent mass excision had varying degrees of postoperative epiphora. Preoperative LDH elevation and NK/T-cell lymphoma, nasal type were associated with poor prognoses.
CONCLUSIONS: Early diagnosis and treatment can lead to a good prognosis for most patients with primary lacrimal sac lymphoma. Mass resection combined with DCR can reduce the occurrence of post-surgical epiphora. The pathology type and tumor marker status are associated with prognosis.
摘要：
目的：确定临床特征，病理类型，肿瘤标志物,治疗,中国原发性泪囊淋巴瘤患者的预后。
方法：本病例回顾性研究分析了15例原发性泪囊淋巴瘤患者。收集的临床数据包括性别，诊断时的年龄，症状,影像学检查结果,病理诊断,病原体鉴定，肿瘤标志物,治疗,后续行动,和预后。使用描述性统计来表征患者。无进展生存期（PFS）定义为从手术到最后一次随访的时间，首次记录肿瘤复发，或死亡。
结果：左眼（n=6）或右眼（n=9）有7名男性和8名女性患有单侧原发性泪囊淋巴瘤。13例患者的最初症状是泪溢，2例患者出现泪囊区红肿。所有的病人最终都出现了泪溢,12个泪囊区有肿块。术前血浆肿瘤标志物分析提示14例同型半胱氨酸升高,9有升高的β2-微球蛋白，2名患者的乳酸脱氢酶（LDH）升高；2名患者的所有三种标志物均升高，1例患者无任何标记物升高。所有患者均接受手术切除，12例患者接受术后化疗。病理类型为DLBCL(n=8),MALT淋巴瘤（n=5），和NK/T细胞淋巴瘤，鼻型（n=2）。平均随访时间为25.8mo（范围：4-41），2例患者死亡。7例接受肿块切除联合泪囊鼻腔吻合术（DCR）的患者术后无泪溢。8例仅接受肿块切除术的患者术后出现不同程度的溢唇。术前LDH升高与NK/T细胞淋巴瘤,鼻型与不良预后相关。
结论：对于大多数原发性泪囊淋巴瘤患者，早期诊断和治疗可以导致良好的预后。肿块切除联合DCR可减少术后泪溢的发生。病理类型和肿瘤标志物状态与预后相关。
方法：本病例回顾性研究分析了15例原发性泪囊淋巴瘤患者。收集的临床数据包括性别，诊断时的年龄，症状,影像学检查结果,病理诊断,病原体鉴定，肿瘤标志物,治疗,后续行动,和预后。使用描述性统计来表征患者。无进展生存期（PFS）定义为从手术到最后一次随访的时间，首次记录肿瘤复发，或死亡。
结果：左眼（n=6）或右眼（n=9）有7名男性和8名女性患有单侧原发性泪囊淋巴瘤。13例患者的最初症状是泪溢，2例患者出现泪囊区红肿。所有的病人最终都出现了泪溢,12个泪囊区有肿块。术前血浆肿瘤标志物分析提示14例同型半胱氨酸升高,9有升高的β2-微球蛋白，2名患者的乳酸脱氢酶（LDH）升高；2名患者的所有三种标志物均升高，1例患者无任何标记物升高。所有患者均接受手术切除，12例患者接受术后化疗。病理类型为DLBCL(n=8),MALT淋巴瘤（n=5），和NK/T细胞淋巴瘤，鼻型（n=2）。平均随访时间为25.8mo（范围：4-41），2例患者死亡。7例接受肿块切除联合泪囊鼻腔吻合术（DCR）的患者术后无泪溢。8例仅接受肿块切除术的患者术后出现不同程度的溢唇。术前LDH升高与NK/T细胞淋巴瘤,鼻型与不良预后相关。
结论：对于大多数原发性泪囊淋巴瘤患者，早期诊断和治疗可以导致良好的预后。肿块切除联合DCR可减少术后泪溢的发生。病理类型和肿瘤标志物状态与预后相关。
