眼表肿物141例临床分析  

Clinical analysis of 141 cases of ocular surface tumors

作　　者：季红[1] 孙丰源[2] 唐东润[2] 

机构地区：[1]天津医科大学眼科临床学院,天津市眼科医院、天津市眼科学与视觉科学重点实验室,天津300020 [2]天津市第一中心医院,天津300192

出　　处：《中国实用眼科杂志》2010年第12期1322-1324,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的 探讨眼表肿物的分类,临床表现及误诊情况.方法 回顾性分析天津市眼科医院自2002年3月至2009年11月间经手术切除并经病理证实的141例眼球表面肿物的病理分类,发病部位及临床表现等情况.结果 141例艮球表面肿瘤中良性肿瘤117例,囊肿29例（24.7%）,皮脂瘤22例（18.8%）,色素痣12例（10.2%）;恶性肿瘤24例,淋巴瘤7例（29.1%）,恶性黑色素瘤6例（25.0%）,上皮内瘤变5例（20.8%）发生在球结膜的肿物最为多见,72例（51.1%）,其次为穹窿结膜30例（21.3%）;角膜缘13例（9.2%）;睑结膜12例（8.5%）;内眦10例（7.1%）;泪阜4例（2.8%）.3例色素痣与恶性黑色素瘤术前难以鉴别;2例上皮内瘤变与鳞状细胞癌不易区分;2例皮脂瘤与皮样肿瘤相混淆;结膜淋巴细胞反应性增生与淋巴瘤术前均较难鉴别.结论 部分眼表肿瘤临床表现较为相似,容易误诊,特别是少见的继发性结膜肿瘤和结膜粘液表皮样癌,提高对它们的正确认识,有助于指导临床诊断.Objective To access the classification clinical features and misdiagnosis of ocular surface tumors. Methods A retrospective study of 141 patients with ocular surface tumors admitted to Tianjin Eye Hospital from March 2002 to November 2009 was undertaken. All of them were comfirmed by histopathologicai biopsy. Clinical records including pathological types, site of lesions and clinical characteristics. Results One hundred and seventeen of 141 tumors were benign, and the most frequent tumors included cyst （29 cases,24.7%）, sebaceoma （22 cases, 18.8%）, nevus （12 cases, 10.2%）; 24 of 141 cases were malignant, the most frequent tumors were lymphadenoma （7 cases, 29.1%）, malignant melanoma （6 cases, 25.0%）, intraepithelial neoplasm （5 cases, 20.8%）. There were 72 （51.1%） cases of tumors exsiting bulbar conjunctiva, which was the most common location. The other sites included fornical conjunctiva （30 cases, 21.3%）, limbal （13 cases,9.2%）, palpebral conjunctiva （12 cases, 8.5%）, inner canthus （10cases, 7.1%）, caruncle （4 cases, 2.8%）. Three cases of pigmented nevus were misdiagnosed as malignant melanoma; 2 cases of intraepithelial neoplasm were difficult to distinguish from squamous cell carcinoma; 2 cases of sebaceoma were hard to differentiate from dermoid cysts. It could not be differentiated clinically between benign and malignant lymphoid tumors. Conclusions Some of the ocular surface tumors can be misdiagnosed because clinical features are similar, especially secondary conjunctival tumors and mucoepidermoid carcinoma ofconjunctiva whose incidence are much lower than others. Raise awareness of them will contribute to the correct diagnosis.

关 键 词：眼表肿瘤 良性 恶性 诊断 

分 类 号：R739.7[医药卫生—肿瘤]