睫状体无色素上皮腺瘤诊治分析  

Adenoma of the nonpigmented ciliary epithelium： an analysis of 5 cases

作　　者：刘显勇[1] 张平[1] 李永平[1] 刘荣娇[1] 林菁[1] 颜建华[1] 

机构地区：[1]中山大学中山眼科中心眼科学国家重点实验室,广州510080

出　　处：《中国实用眼科杂志》2015年第5期547-551,共5页Chinese Journal of Practical Ophthalmology

摘　　要：目的分析睫状体无色素上皮腺瘤患者的临床表现、诊断、病理学特征、手术治疗及预后。方法对中山大学中山眼科中心在2004年10月至2010年10月经病理检查证实的5例睫状体无色素上皮腺瘤患者的临床和病理资料进行回顾性分析。全部病例采用局部板层巩膜睫状体或板层巩膜睫状体前脉络膜切除法治疗，2例肿瘤较大者联合玻璃体切割术。结果5例患者中，男性1例，女性4例；右眼4例，左眼1例，年龄28～46岁，平均38岁，均以视力下降为主诉人院。眼部检查见虹膜根部后方占位、局部虹膜向前隆起，肿瘤由虹膜后方进入瞳孔区，呈灰白色，有时呈半透明状，血管较丰富；均伴晶状体混浊、3例伴晶状体移位。UBM检查显示肿瘤位于睫状体，呈中高回声不均质实性圆形或类圆形肿物，游离缘边界清楚；2例肿瘤较大者合并虹膜囊肿。眼部B超检查示球内前段中高回声边界清楚的类圆形肿物。组织病理学检查：肿物无包膜，瘤细胞为多边形或梭形，呈条状或腺管样排列，胞浆淡染，其内无色素，核呈圆形或梭形，无异型性。免疫组化：Vimentin（＋），S100（＋）、CK（＋），HMB45（-）。经平均随访5．5年，4例视力0．6或以上，1例无光感。全部病例保存眼球，肿物无复发。结论睫状体无色素上皮腺瘤属少见病，可借助UBM等早期发现和诊断，采用手术切除肿物保存眼球的治疗方法效果理想。Objective To analyze the clinical manifestations, diagnosis, pathological characteris- tics, surgical treatment and prognosis in patients with adenoma of the non-pigmented ciliary epitheli- um. Methods The clinical and pathological data in 5 patients, who were seen and diagnosed as ad- enoma of the non-pigmented ciliary epithelium in Zhongshan Ophthalmic Center, Sun Yat-sen Univer- sity from October 2004 to October 2010, were retrospectively reviewed. Results Among all 5 cas- es, 1 was male and 4 were female. The mean age was 38.0 years old （range 28.0 to 46.0 years）. The fight eye was affected in 4 cases and the left in 1 case. All 5 patients were admitted to our hospital with chief complaint of decreased vision. Ophthalmic examination showed that a gray-white, sometimes translucent, mass lay behind the iris root and extend to the area of the pupil, the local iris was pushed forward. The mass was relatively rich in vessels. All complicated with lens opacity and 3 cases with lens dislocation. UBM examination demonstrated that the tumor was located in the ciliary body, it was a round or oval, heterogeneous, moderate- or hyperechoic solid mass, the free edge of the tumor was well-defined. Two cases with larger ciliary tumors also had iris cysts in the same eve. B-mode ultrasound examination also revealed a well-demarcated moderate- or hv^er-echoicround mass at the anterior segment of eye balls. Histopathological examination showed that the surgi- cal mass had no capsule, microscopically, it consisted of polygonal or spindle-shaped tumor cells, ar- ranged in strip or duct-like, the cytoplasm was lightly stained with no pigment, the nuclear was cy- lindrical or spindle-shaped and no atypia cells existed in them. lmmunohistochemistry staining showed positive for Vimentin, S100, CK, and negative for HMB45. All patients were treated with partial lamellar sclera and ciliary body mass excision. Among them, the two cases with larger tu- mors were treated with tumor removal combined with vitrectomy. After an average fol

关 键 词：睫状体 无色素上皮腺瘤 手术 治疗 

分 类 号：R773.3[医药卫生—眼科]