摘要
目的分析3类前部葡萄膜肿物的临床表现、影像学表现及组织病理学特征。方法查阅3例虹膜后方前部葡萄膜肿物的病历资料，分析其自觉症状、影像学表现、不同的手术方法及组织病理学特征。结果3例均有不同的始发症状。睫状体黑色素细胞瘤影像学表现为边界清楚、均质、呈压迫性生长，手术以局部板层巩膜睫状体切除为主，瘤体由体积较大、圆形或多边形黑色素细胞组成，细胞大小均匀一致，细胞内含有大量浓密黑色素颗粒，细胞核小，呈圆形，无细胞异型或病理核丝分裂像；脉络膜黑色素瘤B超表现为“挖空症”、MRI表现为T，长信号，R短信号，增强明显强化，手术以眼球摘除为主，病理学表现肿瘤细胞以梭形细胞为主型，存在细胞异型及病理核丝分裂像；脉络膜炎性渗出性肿物边界清楚，B超表现为低回声隆起，内回声欠均匀，手术以玻璃体切除、渗出性肿物分离切除为主，病理见视网膜色素上皮细胞大部分脱失坏死，脉络膜中可见轻度炎性细胞浸润，无肿瘤细胞。结论熟悉葡萄膜肿物的发病特点、影像学特征，可避免误诊误治；病理组织学检查可确诊。
Objective To analyze clinical features and histopathologic characteristics of three types of anterior uveal tumor. Methods Three cases with anterior uveal tumors behind iris on file were studied for original symptoms, images, surgery procedure and histopathologic characteristics. Results The three pa- tients had different symptom. Ciliary body melanocytoma had clear border, high-amplitude initial echoes in B-scan and pressure growth. The lesion was performed exoresection via partial lamellar sclerouvectomy. Bleached hematoxylin and eosin preparation confirmed a low nuclear-to-cytoplasmic ratio and a central or paracentral nucleus with inconspicuous nucleoli. B-scan of choroidal melanoma showed highly reflective ante- rior border,acoustic hollowness, choroidal excavation. MRI showed long T1 and short T2 signals. Enuclea- tion was performed. Pathologically spindle cell melanoma with nucleoli and mitoses were observed. The ima- ges of inflammatory uveal tumor showed a clear border lesion with low-amplitude initial echoes in B-scan. The main procedure were vitrectomy and resection of the lesion. Retinal pigment epithelium necrosis and choroidal inflammatory cell can be seen by hematoxylin and eosin stain. Conclusion To be familiar with cilinical features and image characteristic of uveal tumor, misdiagnosis can be avoided. The lesion can be con- firmed by pathological examination.
出处
《中华眼外伤职业眼病杂志》
2012年第3期180-183,共4页
Chinese Journal of Ocular Trauma and Occupational Eye Disease
关键词
葡萄膜肿物
病理
临床
Uveal tumor
Histopathology
Clinical
