脉络膜黑色素瘤26例影像学及病理学特点  

The imaging and pathological characteristics of 26 cases ofchoroidal melanoma

作　　者：简天明[1] 唐东润[1] 林锦镛[1] 孙丰源[1] 

机构地区：[1]天津医科大学眼科临床学院,天津市眼科医院,天津市眼科研究所,300020

出　　处：《中国实用眼科杂志》2010年第3期289-291,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的分析脉络膜黑色素瘤的影像学及病理学特点。方法对天津眼科医院1995年4月至2009年5月经病理证实的26例脉络膜黑色素瘤进行回顾性研究，总结其影像学及病理学检查特点，并随访观察手术疗效。结果肿瘤早期症状与肿瘤位置密切相关，眼底和B超检查可发现眼内扁平形肿块，联合彩超、MRI检查多可确诊，并注意与脉络膜出血、转移癌等病变相鉴别。中后期肿瘤继发症状复杂，应避免误诊，影像学检查可见典型蘑菇形、类圆形或半球形肿块，超声、MRI检查具有特殊表现。其中3例影像学检查发现肿瘤向眶内侵犯，行眶内容摘除术，其余23例行眼球摘除术。病理检查结果混合细胞型19例，梭形细胞型4例，上皮细胞型3例，伴巩膜侵犯7例，视神经侵犯3例，眶内侵犯4例。共随访患者12例，平均随访时间23．8个月，均未发现肿瘤复发或全身转移。结论超声、MRI对该肿瘤的诊断和鉴别有较大帮助，眼球摘除仍是目前治疗体积较大脉络膜黑色素瘤的首选方法。Objective To investigate the imaging and pathological characteristics of choroidal melanoma.Methods The pathological data from 26 patients with choroidal melanoma were analyzed retrospectively by means ofultrasonography, CT scan, MRI and pathology.Results Early symptoms of choroidal melanoma were closely associated with tumor location.The examination of B-ultrasonography, color Doppler, CT and MRI showed the imaging characteristics of choroidal melanoma and improved the accuracy in diagnosis.At the early stage, choroidal melanoma must be differentiated from choroidal hemorrhage and metastatic carcinoma.Orbital exenteration was done in 3 cases of mild degrees of extrascleral extension, while 23 cases accepted the enucleation.Twelve cases were followed up from 3 months to 10 years, averagely 23.8 months. Conclusions Ultrasonography and MRI are valuable in the diagnosis and differential diagnosis of choroidal melanoma.Enucleation is an effective treatment method to cure the large-sized choroidal melanoma.

关 键 词：脉络膜黑色素瘤 超声 磁共振成像 手术 病理 

分 类 号：R739.7[医药卫生—肿瘤]