안와 및 안부속기 림프종 환자의 임상양상 및 예후인자의 분석
Analysis of Clinical Features and Prognostic Factor Analysis of Orbital and Adnexal Lymphoma
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목적: 안와 림프종의 임상양상과 병리학적 소견 및 영상학적 소견 및 분류, 치료에 대한 반응과 합병증, 예후에 관계된 인자 등에 대하여 알아보고자 하였다. 대상과 방법: 안와 및 안부속기 림프종으로 진단받은 환자의 의무기록을 토대로 증상, 조직학 및 방사선학적 소견, 치료 반응 및 합병증등을 후향적으로 분석하였다. 진단 당시의 환자 나이와 성별, 방문 시의 증상과 증후, 종괴의 위치와 모양 및 방사선학적인 특징, 병리학적인 소견과 전신검사에 따른 병기, 치료에 대한 반응과 합병증, 예후에 대한 정보를 수집하였다. 결과: 안와 및 안부속기 림프종으로 진단받은 환자는54명이었고 남녀 간에 유의한 차이는 없었으며, 연령은 평균 50.9세(14-82세)였다. 처음 내원 시 안증상은 안검 및 안와주위의 부종이 가장 많았으며, 부위는 결막이 가장 많았다. 조직학적인 분류상 MALT 림프종이가장 많았으며, 치료 중 안 합병증으로 안구건조증이 가장 많았으나 약물 치료에 좋은 반응을 보였다. 종괴의 영상학적 분석에서 종괴의 위치나 모양 등은 예후와 관련성을 찾기 어려웠다. 결론: 안와 및 안부속기 림프종의 대부분은 MALT 림프종이었다. 병기에 따른 적절한 치료는 좋은 반응과 제어율을 보였으며, 안과적합병증은 약물 치료에 반응이 좋았다. 종괴의 영상학적 특징은 예후를 나타내는 인자가 되지 못했다.
Abstract
Purpose: To study the clinical features, pathophysiologic and radiologic characteristics, and prognostic factors in patients with orbital and adnexal lymphoma. Methods: The medical records of patients who were diagnosed with orbital and adnexal lymphoma, and patients who were treated and observed, were retrospectively reviewed. Information regarding age, sex, initial symptoms and signs when visiting the hospital, mass location and features, histology and staging, response to treatment and side effects, and prognosis were collected. Results: Fifty-four patients, with an equal number of men and women, were diagnosed with orbital and adnexal lymphoma. The average age was 50.9 years (14 to 82 years). The main symptom was orbital swelling, and the main site was conjunctiva. Histologically, Mucosa-Associated Lymphoid Tissue (MALT) lymphoma was the most observed. The major ocular complication was dry eye syndrome, which showed good response with ophthalmic treatment. Radiologic features did not have prognostic relevance. Conclusions: Most orbital and adnexal lymphomas were MALT lymphomas. Proper therapy according to stage can result in a good response and remission. In the present study, the therapy complications were well-controlled with medical treatment,and radiologic features of a mass could not be considered as a prognostic factor.
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