原发性虹膜基质囊肿的病理分型及临床特点  

Pathological typing and clinical features 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,455000

出　　处：《中华实验眼科杂志》2015年第10期935-939,共5页Chinese Journal Of Experimental Ophthalmology

摘　　要：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.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

关 键 词：虹膜基质囊肿 原发性 病理分型 临床特点 发病机制 

分 类 号：R773.1[医药卫生—眼科]