CAJ | 학술논문

目的分析原发性虹膜基质囊肿的临床和组织病理学特点.方法回顾性系列病例研究.对天津市眼科医院1979年1月至2012年12月间收治的14例经病理学检查证实的原发性虹膜基质囊肿患者的临床资料和病理学形态进行回顾性分析.结果 14例患者中就诊年龄5个月～50岁,中位数10岁.10例(71.4％)为婴幼儿或青少年期发病,其中8例发病在1岁前;4例(28.6％)为成年期发病;女性10例,男性4例;左眼10例,右眼4例,均为单眼病变.11例表现为半透明或灰白色的虹膜囊性肿物,其中6例位于虹膜下方;2例表现为虹膜弥漫性囊性肿物;另外1例是在因先天性青光眼摘除的眼球内偶被发现.14例中有2例临床首次诊断为先天性青光眼.8例角膜混浊变性、7例继发性青光眼,3例并发性白内障.病理学检查:囊肿位于虹膜表面或虹膜基质层,有9例虹膜囊肿壁由非角化性复层鳞状上皮细胞组成;3例虹膜囊肿壁是由晶状体上皮细胞和晶状体囊膜样组织组成,囊肿与晶状体粘连紧密;另外2例虹膜囊肿壁由单层或复层柱状上皮细胞组成,类似于睫状体上皮.2例伴有晶状体发育异常、3例伴有虹膜组织发育异常、2例伴有睫状体囊肿、1例伴有前房角组织发育异常.结论原发性虹膜基质囊肿多发于婴幼儿或青少年,1岁前发病最多见.多数囊肿来源于结膜上皮组织,少数来源于晶状体上皮或睫状体上皮,部分病例可伴有虹膜、睫状体或晶状体发育异常.
목적 분석원발성홍막기질낭종적림상화조직병이학특점.방법 회고성계렬병례연구.대천진시안과의원1979년1월지2012년12월간수치적14례경병이학검사증실적원발성홍막기질낭종환자적림상자료화병이학형태진행회고성분석.결과 14례환자중취진년령5개월～50세,중위수10세.10례(71.4％)위영유인혹청소년기발병,기중8례발병재1세전;4례(28.6％)위성년기발병;녀성10례,남성4례;좌안10례,우안4례,균위단안병변.11례표현위반투명혹회백색적홍막낭성종물,기중6례위우홍막하방;2례표현위홍막미만성낭성종물;령외1례시재인선천성청광안적제적안구내우피발현.14례중유2례림상수차진단위선천성청광안.8례각막혼탁변성、7례계발성청광안,3례병발성백내장.병이학검사:낭종위우홍막표면혹홍막기질층,유9례홍막낭종벽유비각화성복층린상상피세포조성;3례홍막낭종벽시유정상체상피세포화정상체낭막양조직조성,낭종여정상체점련긴밀;령외2례홍막낭종벽유단층혹복층주상상피세포조성,유사우첩상체상피.2례반유정상체발육이상、3례반유홍막조직발육이상、2례반유첩상체낭종、1례반유전방각조직발육이상.결론 원발성홍막기질낭종다발우영유인혹청소년,1세전발병최다견.다수낭종래원우결막상피조직,소수래원우정상체상피혹첩상체상피,부분병례가반유홍막、첩상체혹정상체발육이상.
Objective To analysis the clinical and pathological characteristics of primary iris stromal cyst.Methods Retrospective cases series study.14 cases of primary iris stromal cyst which were treated in Tianjin Eye Hospital from Jan.1979 to Dec.2012 were collected.They were all proved by pathological results.Their clinical and pathological features were analyzed.Results The age of 14 patients were 5 months to 50 years old,the median is 10 years old.10 patients (71.4％) were attacked from children or adolescence,among which onset age of 8 patients were less than 1-year-old.4 patients (28.6％)occurs when they were adults.10 cases were female and 4 cases were males.10 cases were left eyes,4 cases were right eyes.All cases were unilateral involvement.In these cases,11 cases appeared as a single translucent or gray-white cystic mass on the iris surface,which 6 cases located in the inferior aspect of the iris,2 cases appeared with diffused iris cyst and another 1 case's cyst was found occasionally in the eyeball enucleating specimen.8 cases had corneal opacity or leucoma,7 cases had secondary glaucoma,and 3 cases had complicated cataract.Pathological features showed:cysts located on the iris surface or in the stroma layer.The cysts of 9 cases were constructed of non-cuticular stratified squamous epithelium cells.3 cases' cysts were constructed of lens epithelium cells and lens capsular analogical tissues,and the cysts adhesion to the lenstightly.The other 2 cysts were constructed of single or stratified epithelium cells,similar to ciliary epithelium cells.2 cases complicated with crystalline lens dysplasia,3 cases complicated with iris tissue dysplasia,2 cases complicated with ciliary cysts and 1 case had chamber angle dysplasia.Conclusions Primary iris stoma cyst is rare and it usually occurs in infant,more often in the children less than 1-year-old.Pathological examination showed that most of the cysts originated from the conjunctivaepithelium,minority cysts originated from crystalline lens epithelium or ciliary epithelium.Some cases complicated with iris,ciliary or crystalline lens malformation.