原发性虹膜基质囊肿14例的临床病理学特点  

The clinical and pathological characteristics of 14 cases of primary iris stromal cysts

作　　者：张岩[1] 林锦镛[1] 

机构地区：[1]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市眼科研究所天津医科大学眼科临床学院,300020

出　　处：《中华眼科杂志》2014年第10期747-752,共6页Chinese Journal of Ophthalmology

摘　　要：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.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＆#39;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＆#39; 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

关 键 词：虹膜疾病 囊肿 病理学 临床 

分 类 号：R773.1[医药卫生—眼科]