中华实验眼科杂志
中華實驗眼科雜誌
중화실험안과잡지
Chinese Journal of Experimental Ophthalmology
2015年
10期
935-939
,共5页
虹膜基质囊肿,原发性%病理分型%临床特点%发病机制
虹膜基質囊腫,原髮性%病理分型%臨床特點%髮病機製
홍막기질낭종,원발성%병리분형%림상특점%발병궤제
Iris stromal cysts,primary%Pathological classification%Clinical characteristics%Pathogenesis
背景 原发性虹膜基质囊肿是临床上罕见的眼部病变,近年来组织病理学检查的发现与以往的文献报道有所不同,了解其病理学特点对该病发病机制的研究和精准治疗具有重要意义.目的 对原发性虹膜基质囊肿进行病理分型,并归纳各型的病理特征和临床特点.方法 对1979年1月至2012年12月于天津市眼科医院收治的经病理学检查证实的14例原发性虹膜基质囊肿患者的病理标本进行回顾性研究和分析,依据苏木精-伊红染色、过碘酸希夫染色和免疫组织化学染色特点对原发性虹膜基质囊肿进行病理分型并总结其临床特点.结果 14例原发性虹膜基质囊肿根据其组织病理学表现分为鳞状上皮型9例、晶状体上皮型3例和睫状体上皮型2例.鳞状上皮型囊肿壁由非角化性鳞状上皮细胞组成,部分病例上皮间可见散在的杯状细胞;晶状体上皮型囊肿壁由晶状体囊膜样组织和晶状体上皮细胞组成,囊肿与发育异常的晶状体相连续,2例伴晶状体囊膜不完全闭合和晶状体发育异常;睫状体上皮型囊肿壁由睫状体上皮样细胞组成,1例伴有虹膜睫状体发育异常和前房角组织异常.裂隙灯显微镜下可见鳞状上皮型虹膜基质囊肿多位于颞上方,囊肿呈棕色或灰白色半透明状;晶状体上皮型虹膜囊肿位于颞上方,囊肿呈灰白色半透明状,或弥漫棕色,可伴有晶状体发育异常和白内障;睫状体上皮型虹膜囊肿呈弥漫性隆起,可伴有房角发育异常,早期出现婴幼儿型青光眼,预后较差.结论 原发性虹膜基质囊肿可以分为鳞状上皮型、晶状体上皮型和睫状体上皮型,各型病理形态学表现不同,临床特点和预后也不尽相同.
揹景 原髮性虹膜基質囊腫是臨床上罕見的眼部病變,近年來組織病理學檢查的髮現與以往的文獻報道有所不同,瞭解其病理學特點對該病髮病機製的研究和精準治療具有重要意義.目的 對原髮性虹膜基質囊腫進行病理分型,併歸納各型的病理特徵和臨床特點.方法 對1979年1月至2012年12月于天津市眼科醫院收治的經病理學檢查證實的14例原髮性虹膜基質囊腫患者的病理標本進行迴顧性研究和分析,依據囌木精-伊紅染色、過碘痠希伕染色和免疫組織化學染色特點對原髮性虹膜基質囊腫進行病理分型併總結其臨床特點.結果 14例原髮性虹膜基質囊腫根據其組織病理學錶現分為鱗狀上皮型9例、晶狀體上皮型3例和睫狀體上皮型2例.鱗狀上皮型囊腫壁由非角化性鱗狀上皮細胞組成,部分病例上皮間可見散在的杯狀細胞;晶狀體上皮型囊腫壁由晶狀體囊膜樣組織和晶狀體上皮細胞組成,囊腫與髮育異常的晶狀體相連續,2例伴晶狀體囊膜不完全閉閤和晶狀體髮育異常;睫狀體上皮型囊腫壁由睫狀體上皮樣細胞組成,1例伴有虹膜睫狀體髮育異常和前房角組織異常.裂隙燈顯微鏡下可見鱗狀上皮型虹膜基質囊腫多位于顳上方,囊腫呈棕色或灰白色半透明狀;晶狀體上皮型虹膜囊腫位于顳上方,囊腫呈灰白色半透明狀,或瀰漫棕色,可伴有晶狀體髮育異常和白內障;睫狀體上皮型虹膜囊腫呈瀰漫性隆起,可伴有房角髮育異常,早期齣現嬰幼兒型青光眼,預後較差.結論 原髮性虹膜基質囊腫可以分為鱗狀上皮型、晶狀體上皮型和睫狀體上皮型,各型病理形態學錶現不同,臨床特點和預後也不儘相同.
배경 원발성홍막기질낭종시림상상한견적안부병변,근년래조직병이학검사적발현여이왕적문헌보도유소불동,료해기병이학특점대해병발병궤제적연구화정준치료구유중요의의.목적 대원발성홍막기질낭종진행병리분형,병귀납각형적병리특정화림상특점.방법 대1979년1월지2012년12월우천진시안과의원수치적경병이학검사증실적14례원발성홍막기질낭종환자적병리표본진행회고성연구화분석,의거소목정-이홍염색、과전산희부염색화면역조직화학염색특점대원발성홍막기질낭종진행병리분형병총결기림상특점.결과 14례원발성홍막기질낭종근거기조직병이학표현분위린상상피형9례、정상체상피형3례화첩상체상피형2례.린상상피형낭종벽유비각화성린상상피세포조성,부분병례상피간가견산재적배상세포;정상체상피형낭종벽유정상체낭막양조직화정상체상피세포조성,낭종여발육이상적정상체상련속,2례반정상체낭막불완전폐합화정상체발육이상;첩상체상피형낭종벽유첩상체상피양세포조성,1례반유홍막첩상체발육이상화전방각조직이상.렬극등현미경하가견린상상피형홍막기질낭종다위우섭상방,낭종정종색혹회백색반투명상;정상체상피형홍막낭종위우섭상방,낭종정회백색반투명상,혹미만종색,가반유정상체발육이상화백내장;첩상체상피형홍막낭종정미만성륭기,가반유방각발육이상,조기출현영유인형청광안,예후교차.결론 원발성홍막기질낭종가이분위린상상피형、정상체상피형화첩상체상피형,각형병리형태학표현불동,림상특점화예후야불진상동.
Background Primary iris stromal cysts is a rare clinical disease.In recent years,the pathological findings of primary iris stromal cysts are different from previous literature reports.It is very important to understand the pathological characteristics of primary iris stromal cysts for illuminating its pathogenesis and accurate treatment.Objective This study was to analyze the pathological types and clinical manifestations of primary iris stromal cysts.Methods Histopathological sections of 14 patients with primary iris stromal cysts from January 1979 to December 2012 in Tianjin Eye Hospital were retrospectively analyzed.The primary iris stromal cysts were typed based on the hematoxylin-eosin staining,periodic acid-Schiff (PAS) staining and immunochemistry, and the clinical chacteristics upon different types were evaluated.Results In 14 specimens of primary iris stromal cysts,squamous epithelial type was found in 9 specimens,lens epithelial type in 3 specimens and ciliary body epithelial type in 2 specimens.The primary iris stromal cysts of squamous epithelial type were constituted of non-cuticular stratified squamous epithelium cells,and sporadic goblet cells were found in some specimens.The primary iris stromal cysts of lens epithelial type were consisted of lens epithelium cells and lens capsular analogic tissue and the cysts were tightly adherent to the lens.Crystalline lens dysplasia were seen in 2 specimens.The primary iris stromal cysts of ciliary body epithelial type showed single or stratified ciliary body like epithelium cells.Iris-ciliary dysplasia or anterior chamber angle abnormality was displayed in 1 specimen in this type of cysts.Under the slit lamp microscope,superior-temporal clear cysts were often seen in the primary iris stromal cysts of squamous epithelial type, and translucent cysts or diffuse swelling cysts were exhibited in the lens epithelial type and might be accompanied with lens dysplasia and cataract.Diffuse swelling was found in the cysts of ciliary body epithelial type which were often associated with chamber dysplasia and infantile glaucoma.Conclusions Primary iris stromal cysts are pathologically classified into squamous epithelial type, lens epithelial type and ciliary body epithelial type and present with different clinical appearances.
