Abstract：Objective: To investigate the clinicopathologic features of 141 patients suffering from sustained lacrimal gland occupying lesions. Methods: Retrospective series of case studies. The clinical data of 141 patients having sustained lacrimal gland occupying lesions from June 2019 to October 2021 in the Second Hospital of Jilin University were selected, including gender, age, clinical manifestations, imaging examinationand histopathological diagnosis. The clinical and imaging features of lacrimal gland lesions were delved into as per the classification of pathological diagnosis. An independent sample t-test or nonparametric rank-sum test was used for comparison between groups. The classification variables were expressed in terms of case number and percentage, and the Chi-square test and/or Fisher exact probability method were used for comparison between groups. Result: 141 patients, including 50 males and 91 females,were recruited. According to the nature of lesions, 117 cases (83.0%) were benign lesions, and the most common disease was found to be IgG4-related dacryoadenitis, 55 cases. 24 cases (17.0%) were malignant tumours, and the most common disease was lymphoma accounting for 10 cases. The average age of benign lesions (45.8±15.7 years) is younger than that of malignant lesions (56.3±16.2 years) and the difference was statistically significant (Z=-3.23, P=0.001). According to the frequency, there were 72 cases of inflammatory diseases (51.1%), 33 cases of epithelial diseases (23.4%) and 17 cases of lymphatic system diseases (12.1%). Lacrimal occupying lesions were divided into three groups: dacryoadenitis,lymphoproliferative and epithelial tumours. Besides, among the three groups, the gender ratio, clinical manifestations (eyelid swelling, proptosis, limited ocular motility and decreased vision), imaging manifestations (bilateral involvement, orbital bone changes, rhinosinusitis), all of these results possessed statistical significance (P<0.05). However, there was no significant difference in ocular pain, thickened extraocular muscle and enlarged trigeminal nerve among the three groups. Pairwise comparisons were between groups, epithelial tumors compared to dacryoadenitis, the former has affected a lower proportion of females, eyelid swelling, bilateral involvement and rhinosinusitis(χ2=17.01, P<0.001; χ2=32.34,
P<0.001; χ2=10.43, P=0.001; χ2=10.12, P=0.001), a higher proportion of proptosis, limited ocular motility, decreased vision and bone destruction were statistically significant (χ2=18.71, P<0.001; χ2=7.64, P=0.006; χ2=7.32, P=0.012); Additionally, epithelial tumours were compared to lymphoproliferative lesions, and it was found that the former has a lower proportion of eyelid swelling and bilateral involvement, but a higher proportion of proptosis, with a statistically significant difference (χ2=15.93, P<0.001; χ2=6.38,P=0.012;χ2=10.14, P=0.001); The difference was statistically significant only in bilateral involvement between the dacryoadenitis and lymphoproliferative lesions groups(χ2=10.43, P=0.001). Besides, there was nosignificant difference in the remaining clinical and imaging manifestations of lymphoproliferative lesions compared with dacryoadenitis and epithelial tumours. No epithelial tumours were found in 7 children with lacrimal gland space occupying lesions. Conclusion: Inflammatory diseases are the most common occupying lesions of the lacrimal gland, followed by epithelial tumours. The average age of benign lesions is less than that of malignant lesions. The distribution of lacrimal gland lesions in children differs from those in adults. The clinical and imaging manifestations of lacrimal gland dacryoadenitis and epithelial tumours contain conspicuous differences which are readily distinguishable.
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