文章摘要

睫状体无色素上皮腺瘤1例

作者: 1胡蓉, 2张科, 3朱小华, 3周亮
1 湖南省人民医院(湖南师范大学第一附属医院)眼科,长沙 410011
2 中南大学湘雅二医院病理科,长沙 410011
3 中南大学湘雅二医院眼科,长沙 410011
通讯: 朱小华 Email: zxh600705@163.com
周亮 Email: zhouliang12@csu.edu.cn
DOI: 10.3978/j.issn.2095-6959.2021.05.037
基金: 国家自然科学基金(81200697)。

摘要

1例35岁男性患者因为左眼视物模糊就诊,最初考虑睫状体黑色素瘤,术后病理提示为睫状体无色素上皮腺瘤。该患者否认家族史、外伤史及手术史。因“左眼视物模糊6年,左眼视力明显下降伴眼红眼胀2周”,初诊于湖南省人民医院眼科门诊,眼眶MRI提示左眼晶状体下方占位病变,性质待定,黑色素瘤诊断为“左眼继发性青光眼,左眼并发性白内障,左眼睫状体肿物,性质待查,双眼屈光不正”,给予降眼压药物处理后眼压下降,但左眼视物模糊及眼红症状无明显改善。随后就诊于中南大学湘雅二医院眼科。入院后专科检查及辅助检查均提示左眼睫状体占位,于全身静脉麻醉下行左眼经巩膜肿瘤切除+晶状体超声乳化吸除+人工晶体植入+玻璃体切割术。术后病理检查可见肿瘤组织由大量增生的柱状或立方状无色素上皮细胞构成,瘤细胞呈条索、片状或管状排列,免疫组织化学显示CK18(+)、S-100(+)、Vim(+)、GFA P(+)、CEA(–)、P63(–)、CK5/6(–)。最终诊断为睫状体无色素上皮腺瘤,提示临床医生面对睫状体肿瘤时应注意避免漏诊与误诊。
关键词: 睫状体肿瘤;无色素上皮细胞;腺瘤;病理诊断

A case of adenoma of nonpigmented ciliary epithelium

Authors: 1HU Rong, 2ZHANG Ke, 3ZHU Xiaohua, 3ZHOU Liang
1 Department of Ophthalmology, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha 410011, China
2 Department of Pathology, Second Xiangya Hospital, Central South University, Changsha 410011, China
3 Department of Ophthalmology, Second Xiangya Hospital, Central South University, Changsha 410011, China

CorrespondingAuthor: ZHU Xiaohua Email: zxh600705@163.com

DOI: 10.3978/j.issn.2095-6959.2021.05.037

Foundation: This work was supported by the National Natural Science Foundation of China (81200697).

Abstract

A 35-year-old male patient was initially diagnosed with ciliary body melanoma due to blurred vision in the left eye, but postoperative pathology suggested adenoma of nonpigmented ciliary epithelium. He denied any family history, trauma or surgery history. He initially visited the ophthalmic outpatient department of Hunan Provincial People’s Hospital due to “blurred vision in the left eye for 6 years, significant decrease in visual acuity of the left eye with red eye swelling for 2 weeks. The orbital MRI showed an occupying lesion under the lens of the left eye, but its property was to be determined. The melanoma was diagnosed as “secondary glaucoma in the left eye, complicated cataract in the left eye, ciliary body mass with undetermined property in the left eye, binocular refractive error”. The intraocular pressure decreased after the treatment with drugs, but there was no significant improvement in the symptoms of visual blurring and ocular redness in the left eye. Then the patient was admitted to the Second Xiangya Hospital of Central South University. Both the speciality examination and the auxiliary examination indicated that the ciliary body of the left eye was occupied. Under general intravenous anesthesia, the left eye was treated with transscleral tumor resection, lens phacoemulsification, intraocular lens implantation and vitrectomy. Postoperative pathological examination showed that the tumor tissue was composed of a large number of proliferating columnar or cubic non-pigmented epithelial cells, and the tumor cells were arranged in cords, sheets or tubes. Immunohistochemistry showed CK18(+), s-100(+), Vim(+), GFA P(+), CEA(–), P63(–), ck5/6(–). The final diagnosis was adenoma of nonpigmented ciliary epithelium. It suggested that clinicians should pay attention to avoid missed diagnosis and misdiagnosis of ciliary body tumor.
Keywords: ciliary body tumor; non-pigmented epithelial; adenoma; pathological diagnosis