中华眼外伤职业眼病杂志
中華眼外傷職業眼病雜誌
중화안외상직업안병잡지
CHINESE JOURNAL OF OCULAR TRAUMA AND OCCUPATIONAL EYE DISEASE
2012年
3期
180-183
,共4页
葡萄膜肿物%病理%临床
葡萄膜腫物%病理%臨床
포도막종물%병리%림상
Uveal tumor%Histopathology%Clinical
目的 分析3类前部葡萄膜肿物的临床表现、影像学表现及组织病理学特征.方法 查阅3例虹膜后方前部葡萄膜肿物的病历资料,分析其自觉症状、影像学表现、不同的手术方法 及组织病理学特征.结果 3例均有不同的始发症状.睫状体黑色素细胞瘤影像学表现为边界清楚、均质、呈压迫性生长,手术以局部板层巩膜睫状体切除为主,瘤体由体积较大、圆形或多边形黑色素细胞组成,细胞大小均匀一致,细胞内含有大量浓密黑色素颗粒,细胞核小,呈圆形,无细胞异型或病理核丝分裂像；脉络膜黑色素瘤B超表现为“挖空症”、MRI表现为T1长信号,T2短信号,增强明显强化,手术以眼球摘除为主,病理学表现肿瘤细胞以梭形细胞为主型,存在细胞异型及病理核丝分裂像；脉络膜炎性渗出性肿物边界清楚,B超表现为低回声隆起,内回声欠均匀,手术以玻璃体切除、渗出性肿物分离切除为主,病理见视网膜色素上皮细胞大部分脱失坏死,脉络膜中可见轻度炎性细胞浸润,无肿瘤细胞.结论 熟悉葡萄膜肿物的发病特点、影像学特征,可避免误诊误治；病理组织学检查可确诊.
目的 分析3類前部葡萄膜腫物的臨床錶現、影像學錶現及組織病理學特徵.方法 查閱3例虹膜後方前部葡萄膜腫物的病歷資料,分析其自覺癥狀、影像學錶現、不同的手術方法 及組織病理學特徵.結果 3例均有不同的始髮癥狀.睫狀體黑色素細胞瘤影像學錶現為邊界清楚、均質、呈壓迫性生長,手術以跼部闆層鞏膜睫狀體切除為主,瘤體由體積較大、圓形或多邊形黑色素細胞組成,細胞大小均勻一緻,細胞內含有大量濃密黑色素顆粒,細胞覈小,呈圓形,無細胞異型或病理覈絲分裂像；脈絡膜黑色素瘤B超錶現為“挖空癥”、MRI錶現為T1長信號,T2短信號,增彊明顯彊化,手術以眼毬摘除為主,病理學錶現腫瘤細胞以梭形細胞為主型,存在細胞異型及病理覈絲分裂像；脈絡膜炎性滲齣性腫物邊界清楚,B超錶現為低迴聲隆起,內迴聲欠均勻,手術以玻璃體切除、滲齣性腫物分離切除為主,病理見視網膜色素上皮細胞大部分脫失壞死,脈絡膜中可見輕度炎性細胞浸潤,無腫瘤細胞.結論 熟悉葡萄膜腫物的髮病特點、影像學特徵,可避免誤診誤治；病理組織學檢查可確診.
목적 분석3류전부포도막종물적림상표현、영상학표현급조직병이학특정.방법 사열3례홍막후방전부포도막종물적병력자료,분석기자각증상、영상학표현、불동적수술방법 급조직병이학특정.결과 3례균유불동적시발증상.첩상체흑색소세포류영상학표현위변계청초、균질、정압박성생장,수술이국부판층공막첩상체절제위주,류체유체적교대、원형혹다변형흑색소세포조성,세포대소균균일치,세포내함유대량농밀흑색소과립,세포핵소,정원형,무세포이형혹병리핵사분렬상；맥락막흑색소류B초표현위“알공증”、MRI표현위T1장신호,T2단신호,증강명현강화,수술이안구적제위주,병이학표현종류세포이사형세포위주형,존재세포이형급병리핵사분렬상；맥락막염성삼출성종물변계청초,B초표현위저회성륭기,내회성흠균균,수술이파리체절제、삼출성종물분리절제위주,병리견시망막색소상피세포대부분탈실배사,맥락막중가견경도염성세포침윤,무종류세포.결론 숙실포도막종물적발병특점、영상학특정,가피면오진오치；병리조직학검사가학진.
Objective To analyze clinical features and histopathologic characteristics of three types of anterior uveal tumor.Methods Three cases with anterior uveal tumors behind iris on file were studied for original symptoms,images,surgery procedure and histopathologic characteristics.Results The three patients had different symptom.Ciliary body melanocytoma had clear border,high-amplitude initial echoes in B-scan and pressure growth.The lesion was performed exoresection via partial lamellar sclerouvectomy.Bleached hematoxylin and eosin preparation confirmed a low nuclear-to-cytoplasmic ratio and a central or paracentral nucleus with inconspicuous nucleoli.B-scan of choroidal melanoma showed highly reflective anterior border,acoustic hollowness,choroidal excavation.MRI showed long T1 and short T2 signals.Enucleation was performed.Pathologically spindle cell melanoma with nucleoli and mitoses were observed.The images of inflammatory uveal tumor showed a clear border lesion with low-amplitude initial echoes in B-scan.The main procedure were vitrectomy and resection of the lesion.Retinal pigment epithelium necrosis and choroidal inflammatory cell can be seen by hematoxylin and eosin stain.Conclusion To be familiar with cilinical features and image characteristic of uveal tumor,misdiagnosis can be avoided.The lesion can be confirmed by pathological examination.
