涙囊部腫瘤性疾患の頻度と画像診断の有用性についての検討

Incidence of tumors in the lacrimal sac area and usefulness of diagnostic imaging

要約　目的：涙囊部の腫瘤性疾患の頻度と画像診断の有用性の報告。対象と方法：2011年までの91か月間に松山赤十字病院眼科で画像診断または病理組織診断を行った涙囊部腫瘤22例を対象とした。結果：涙囊腫瘍は，悪性リンパ腫2例，腺癌1例，悪性好酸性顆粒細胞腫1例で，慢性涙囊炎が4例あった。涙囊周囲の腫瘤では，副鼻腔粘液囊胞7例，囊胞5例，悪性リンパ腫2例があった。副鼻腔粘液囊胞ではCTで副鼻腔との連続病変が証明できたが，CTとMRIでも慢性涙囊炎と囊胞性疾患との鑑別が困難な症例では，涙囊造影が有用であった。結論：涙囊部腫瘤は悪性腫瘍であることが多い。画像診断法を活用して正確な診断をすることが重要である。

Abstract.　Purpose：To report the incidence of tumors in the lacrimal sac area and usefulness of diagnostic imaging. Cases and Method：This retrospective study was made on 22 cases of tumor in the lacrimal sac area who received diagnostic imaging or histopathological study at Matsuyama Red Cross Hospital during 91 months through 2011. Results：Tumor of the lacrimal sac comprised malignant lymphoma 2 cases,adenocarcinoma 1 case,malignant oncocytoma 1 case and chronic dacryocystitis 4 cases. Tumors adjacent to the lacrimal sac comprised mucocele 7 cases,cyst 5 cases and malignant lymphoma 2 cases. Computed tomography（CT）was useful in the diagnosis of mucocele by showing extension to the paranasal sinus. Dacryocystography was useful in the differentitation of chronic dacryocystitis from cystic lesion when CT and MRI findings were undecisive. Conclusion：There is a high incidence of malignancy in tumors in the lacrimal sac area. Diagnostic imaging may be helpful in ambiguous cases.