原发性结膜肿瘤728例临床病理分析

目的 了解眼部原发性结膜肿瘤的组织病理学特征及发病率.方法 收集第三军医大学附属西南眼科医院2003年1月至2009年12月期间门诊及住院治疗的728例原发性结膜肿瘤的临床病理资料进行回顾性分析.结果 良性结膜肿瘤570例(78.3%),其构成位于前10位的依次为:色素痣、结膜囊肿、乳头状瘤、血管瘤、迷芽瘤(皮样瘤、皮样脂肪瘤、畸胎样瘤)、脂肪瘤及纤维脂肪瘤、反应性淋巴增生、黑变病、非典型性增生、皮脂腺瘤.恶性结膜肿瘤158例(21.7%),其构成位于前5位的分别是:鳞状细胞癌(含黏液表皮样癌)、恶性淋巴瘤、恶性黑色素瘤、浆细胞瘤、原位癌.对结膜鳞状细胞性肿物及黑色素性病变的临床、病理特征及鉴别诊断进行了总结分析.结论 结膜肿瘤临床及病理分类繁多,对病变进行临床及病理分析有助于正确的诊断及治疗.     

426例眼部肿瘤病理分析

目的:对426例眼部肿瘤进行病理分析。方法:复习我院病理科1982～1997年间所检查的457例眼科病理资料,对其中的426例眼部肿瘤进行分析。结果:良性肿瘤290例（68.1％）,恶性肿瘤136例（31.9％）。按发病解剖学部位分类:眼睑肿瘤272例（63.8％）,角结膜肿瘤44例（10.3％）,视网膜肿瘤34例（8％）,眼眶肿瘤76例（17.8％）。按组织学分类,眼睑良性肿瘤前5位为色素痣83例,各种囊肿39例,基底细胞乳头状瘤34例,鳞状上皮乳头状瘤17例,脉管瘤14例。眼睑恶性肿瘤为:基底细胞癌33例,鳞状细胞癌16例,睑板腺癌10例,恶性黑色素瘤7例。角结膜肿瘤较少。视网膜肿瘤34例,全部为视网膜母细胞瘤。眼眶良性肿瘤前5位为:各种上皮性囊肿17例,神经纤维瘤10例,泪腺混合瘤10例,炎性假瘤9例,血管瘤5例。眼眶恶性肿瘤以鳞状细胞癌10例占首位,其余依次为泪腺混合瘤恶变4例、基底细胞癌2例,间叶组织来源的血管肉瘤、平滑肌肉瘤、横纹肌肉瘤各1例。     

眼球表面肿瘤116例临床分析

报告眼球表面肿瘤１１６例，其中恶性肿瘤２３例，占１９．８％，良性肿瘤９３例，占８０．２％，恶性肿瘤以鳞状细胞癌最多见，早期局部手术切除预后良好。良性肿瘤中色素痣占第一位，应注意与黑色素瘤鉴别，如怀疑为恶性黑色素瘤，则应及早进行活检或彻底手术切除。     

眼球表面肿瘤116例临床分析

报告眼球表面肿瘤１１６例，其中恶性肿瘤２３例，占１９．８％；良性肿瘤９３例，占８０．２％。恶性肿瘤以鳞状细胞癌最多见，早期局部手术切除预后良好。良性肿瘤中色素痣占第一位，应注意与黑色素瘤鉴别，如怀疑为恶性黑色素瘤，则应及早进行活检或彻底手术切除。     

原发性眼睑肿瘤291例临床病理分析

目的:了解原发性眼睑肿瘤的组织病理学特征及发病率。方法:收集第三军医大学附属西南眼科医院2003-01/2009-12门诊及住院治疗的291例原发性眼睑肿瘤患者的临床病理资料进行回顾性分析。结果:良性眼睑肿瘤172例(59.1%),其构成位于前10位的依次为:乳头状瘤、色素痣、炎性肉芽肿、皮样囊肿或表皮样囊肿、淀粉样变性、疣、血管瘤、黄色瘤、浆细胞肉芽肿、毛发上皮瘤。恶性眼睑肿瘤119例(40.9%),其构成位于前5位的肿瘤依次为:基底细胞癌、鳞状细胞癌(含梭形细胞癌)、皮脂腺癌、恶性淋巴瘤、恶性黑色素瘤。对眼睑三大恶性肿瘤的临床流行病学资料进行了总结分析,讨论了眼睑肿瘤切除术后的眼睑修复方法。结论:眼睑肿瘤临床病理分类繁多,对病变进行临床病理分析有助于正确的诊断及治疗。     

眼表肿物141例临床分析

目的 探讨眼表肿物的分类,临床表现及误诊情况.方法 回顾性分析天津市眼科医院自2002年3月至2009年11月间经手术切除并经病理证实的141例眼球表面肿物的病理分类,发病部位及临床表现等情况.结果 141例艮球表面肿瘤中良性肿瘤117例,囊肿29例(24.7%),皮脂瘤22例(18.8%),色素痣12例(10.2%);恶性肿瘤24例,淋巴瘤7例(29.1%),恶性黑色素瘤6例(25.0%),上皮内瘤变5例(20.8%)发生在球结膜的肿物最为多见,72例(51.1%),其次为穹窿结膜30例(21.3%);角膜缘13例(9.2%);睑结膜12例(8.5%);内眦10例(7.1%);泪阜4例(2.8%).3例色素痣与恶性黑色素瘤术前难以鉴别;2例上皮内瘤变与鳞状细胞癌不易区分;2例皮脂瘤与皮样肿瘤相混淆;结膜淋巴细胞反应性增生与淋巴瘤术前均较难鉴别.结论 部分眼表肿瘤临床表现较为相似,容易误诊,特别是少见的继发性结膜肿瘤和结膜粘液表皮样癌,提高对它们的正确认识,有助于指导临床诊断.     

结膜原发性肿块422例的临床病理探讨

目的:分析结膜原发性肿块的病理学特点,探讨部分肿块发生的过程及病因,提高结膜肿块诊断的准确性.方法:回顾性分析422例结膜肿块的临床表现、组织学特点及免疫组化结果,复习文献.结果:原发性结膜肿块422例中,良性肿块403例(95.5%),恶性肿块19例(4.5%).良性肿块中,鳞状细胞乳头状瘤71例(17.6%),结膜囊肿68例(16.9%),炎性肿块62例(15.4%),色素痣60例(14.9%), 皮样脂肪瘤58例(14.4%).恶性肿块中,B细胞淋巴瘤6例(31.6%),黑色素瘤6例(31.6%),鳞状细胞癌5例(26.3%).部分肿块的发生有共同的诱因.结论:结膜原发肿块病理类型丰富,部分病理类型间有一定相关性,以良性肿块为主.为保证病理诊断的准确性,降低误诊率,应在形态学的基础上结合免疫组化检查确诊.     

原发性结膜肿瘤728例临床病理分析

目的 了解眼部原发性结膜肿瘤的组织病理学特征及发病率.方法 收集第三军医大学附属西南眼科医院2003年1月至2009年12月期间门诊及住院治疗的728例原发性结膜肿瘤的临床病理资料进行回顾性分析.结果 良性结膜肿瘤570例(78.3%),其构成位于前10位的依次为:色素痣、结膜囊肿、乳头状瘤、血管瘤、迷芽瘤(皮样瘤、皮样脂肪瘤、畸胎样瘤)、脂肪瘤及纤维脂肪瘤、反应性淋巴增生、黑变病、非典型性增生、皮脂腺瘤.恶性结膜肿瘤158例(21.7%),其构成位于前5位的分别是:鳞状细胞癌(含黏液表皮样癌)、恶性淋巴瘤、恶性黑色素瘤、浆细胞瘤、原位癌.对结膜鳞状细胞性肿物及黑色素性病变的临床、病理特征及鉴别诊断进行了总结分析.结论 结膜肿瘤临床及病理分类繁多,对病变进行临床及病理分析有助于正确的诊断及治疗.

Abstract：

Objective To investigate the histopathologic features and incidence of primary conjunctival neoplasms. Methods The histopathologic data of 728 primary conjunctival neoplasms in Southwest Eye Hospital from January of 2003 to December of 2009 were collected and analyzed retrospectively. Results Benign conjunctival neoplasms were 570(78.3%), the top ten in the ranking in turn were pigmented nevus, conjunctival cyst, papilloma, hemangioma, Choristoma, lipoma and lipofibroma, Reactive Lymphoid Hyperplasia,melanosis, atypical hyperplasia, sebaceous adenoma. Malignant conjunctival neoplasms were 158(21.7%), the top five in the ranking in turn were squamous cell carcinoma, malignant lymphoma, plasmocytoma, carcinoma in situ. The clinical, pathological and differential diagnosis of conjunctival squamous cell neoplasms and melanin lesions were summarized. Conclusions The classification of conjunctival neoplasms are various, the clinical and pathological analysis of primary conjunctival neoplasms is helpful to the diagnosis and therapy.     

眼睑恶性肿瘤的临床分析

目的分析眼睑恶性肿瘤的临床病理类型和治疗方法。方法对74例眼睑恶性肿瘤患者进行病例回顾性分析。其中,男性35人,女性39人,肿瘤部位:右眼38人,左眼36人,上睑25人,下睑49人,年龄28岁～84岁,平均60.74岁。病理诊断示:基底细胞癌39例,睑板腺癌22例,鳞状上皮细胞癌7例,恶性黑色素瘤4例,小细胞癌1例,小细胞恶性淋巴瘤1例。均采用手术治疗,其中6例因肿瘤侵及眶内,行眶内容剜出术,其余病例皆手术切除肿瘤,于术中送冰冻切片控制切缘(Mohs法)以保证术中完全切除肿瘤组织。眼睑缺损一期手术修复。结果6例行眶内容剜出术患者术后遗留明显的眼眶畸形,须二期行眼眶赝复或眼眶畸形整复术。68例术后眼睑外观满意,视功能无影响。结论眼睑恶性肿瘤多发生于老年人,其中基底细胞癌居第一位,其次为睑板腺癌,鳞状上皮细胞癌占第三位。治疗为手术切除加一期缺损修复,睑板结膜瓣滑行修复眼睑缺损具有操作方便、术后眼睑外形满意的优点。     

653例结膜肿块病理学分析

目的 常见结膜肿块的病理学分析。方法 收集上海市眼耳鼻喉医院眼科病理室存档的653例结膜肿块标本进行回顾性分析。结果 在653例结膜肿块中，良性病变523例(80．1％)；癌前期病变30例(4．6％)；恶性病变100例(15．3％)。良性肿块共523例，前三位分别为囊肿、炎症和色素痣。恶性肿块共100例，前三位分别为鳞状细胞癌、恶性黑色素瘤和淋巴瘤。结论 通过大量的病理样本统计分析及相应疾病的病理学特性的分析比较，有助于临床对结膜肿块的诊断。     

Incidence of benign and malignant lesions of eyelid and conjunctival tumors

PURPOSE: To examine the incidence of benign and malignant eyelid lesions and conjunctival tumors. SUBJECTS AND METHODS: One-hundred-and twenty-eight cases (131 eyes) which were treated during the period from January 1990 to February 2004 were histopathologically diagnosed for eyelid or conjunctival tumors (87 cases of eyelid tumors and 41 cases of conjunctival tumors) in retrospective evaluations. The incidence of benign or malignant lesions, the pathological classification, age, sex, and clinical diagnostic accuracy were all investigated. RESULTS: Sixty-four (73%) of the tumors were found to be benign eyelid tumors. The common benign eyelid tumors were 14 nevocellular nevi, 9 seborrheic keratosis, 7 epidermoid cysts, and 6 papillomas. Twenty-four (27%) eyelid tumors were malignant. These included 9 basal cell carcinomas, 9 sebaceous gland carcinomas, 4 malignant lymphomas, and 2 metastatic tumors. Thirty-four (79%) conjunctival tumors were benign, and the common benign conjunctival tumors were 9 nevocellular nevi and 7 papillomas. Nine (21%) conjunctival tumors were malignant, comprising 7 malignant lymphomas and 2 squamous cell carcinomas. The mean ages of malignant eyelid and conjunctival tumor patients were significantly older than those of benign tumor patients. Clinical accuracy in predicting basal cell carcinoma and sebaceous gland carcinoma was 11.1% and 44.4%, respectively. CONCLUSIONS : Approximately 70 approximately 80% of all eyelid and conjunctival tumors are benign. Clinicians should suspect that the lesions are malignant when seeing elderly patients with eyelid or conjunctival tumors. Excised eyelid lesions should be submitted for histopathologic confirmation because there are some cases where clinical diagnosis does not match pathological diagnosis.     

Survey of 447 Patients with Conjunctival Neoplastic Lesions in Farabi Eye Hospital,Tehran, Iran

Purpose: The current study was undertaken to determine the frequency of specific primary conjunctival neoplastic lesions in a patient population treated at an ocular service over a 15-year period. Materials and Methods: We analyzed the data of all primary cases of conjunctival neoplasia diagnosed from 1990 to 2004 in the pathology department of Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran. Results: Of 3,242 conjunctival specimens, 447 were identified as primary conjunctival neoplasms. The patient group comprised 270 (60.4%) males and 177 (39.6%) females, with an age range of 1 to 90 years. The mean age was 38 years and the median was 32 years. The most common primary conjunctival neoplastic lesion was nevus (38.7%), followed by squamous cell carcinoma, (25.1%), papilloma (7.8%), dysplasia (5.6%), and hemangioma (5.1%), respectively. Of 447 lesions, 261 (58.4%) were benign, 134 (30%) were malignant, and 52 (11.6%) were precancerous. Conclusion: As in previously published studies, benign lesions were the most frequent, but the percent of malignant lesions was much higher than that described in other reports. The high percentage of squamous cell carcinoma that we observed can likely be attributed to elevated sun exposure and ultraviolet light in Iran. The characterization of precancerous lesions in this study emphasizes their potential to transform into malignant lesions and the need for sufficient early management and follow up.     

Smart phone apps every ophthalmologist should know about

AIM: To evaluate the demographic features, location, and histopathologic results in primary eyelid tumors. METHODS: We retrospectively reviewed the records of patients with primary eyelid tumor diagnosed and treated between November 1997 and 2016 on our service. Results: Nine hundred and eleven lesions from 874 patients were included in this study. Four hundred and forty-six (51.0%) of the patients were females and 428 (49.0%) were males. The mean age was 51.0y (range: 3mo-94y). The lesions were located in the upper eyelid (418 cases, 45.9%), lower eyelid (378 cases, 41.5%), medial canthus (89 cases, 9.8%), and lateral canthus (26 cases, 2.9%). Four hundred and seventy (51.6%) lesions were located on the right side and 441 (48.4%) on the left. Of the eyelid lesions, 666 (73.1%) were benign, 230 (25.2%) malignant, and 15 (1.6%) premalignant. When the eyelid tumors were classified according to their tissue or cell of origin, 527 (57.8%) of the lesions were found to be epidermal, 171 (18.8%) adnexal, 131 (14.4%) inflammatory and infectious, and 65 (7.1%) stromal. The most common benign lesions were squamous cell papilloma (139 lesions, 15.2%), intradermal nevus (97 lesions, 10.6%), epidermoid inclusion cysts (78 lesions, 8.6%), seborrheic keratosis (60 lesions, 6.6%), and inflammatory masses (59 lesions, 6.5%). Basal cell carcinoma was the most common malignant tumor (191 lesions, 21.0%) followed by squamous cell carcinoma (16 lesions, 1.8%), sebaceous carcinoma (14 lesions, 1.5%), and malignant melanoma (5 lesions, 0.5%). CONCLUSION: In this study, 73.1% of eyelid lesions were benign and the remaining 26.9% were premalignant and malignant. Basal cell carcinoma was the most common tumor among all histopathological diagnosis followed by squamous papilloma.     

A retrospective study of 2228 cases with eyelid tumors

AIM: To describe the histopathologic and clinical features of eyelid tumor cases from Tianjin Eye Hospital during 2002 to 2015. METHODS: In this retrospective study, a total of 2228 cases of eyelid tumors with pathologic diagnoses were enrolled. The eyelid tumors were classified into three groups according to tumor origin: epidermal, adnexal and miscellaneous, including melanocytic, neural and vascular lesions. Inflammatory tumor-like lesions were excluded. The clinical characteristics of the eyelid tumors were analyzed, including age, gender and lesion location. RESULTS: Most eyelid tumors were epidermal in origin (1080, 48.5%), followed by miscellaneous (885, 39.7%) and adnexal tumors (263, 11.8%). Among all the tumors, 292 (13.1%) were malignant lesions, 1910 (85.7%) benign and 26 (1.1%) premalignant lesions. Most malignant tumors originated from epidermal cells (60.0%), followed by adnexal cells (34.6%). The most common malignant tumors were basal cell carcinomas (56.5%) followed by sebaceous carcinoma (34.6%), squamous cell carcinomas (3.8%) and lymphoma/plasmocytoma (1.7%). The benign and premalignant eyelid lesions mostly originated from epidermal cells (46.4%) followed by miscellaneous cell sources (45.2%), including melanocytic nevus (33.8%), seborrheic keratosis (13.7%), squamous cell papilloma (13.0%) and epidermal cysts (11.5%). CONCLUSION: Eyelid tumors are mostly epithelial in origin. Benign tumors are significantly more common than malignant tumors with an obvious female predominance, and the most frequent malignant tumor are basal cell carcinoma, sebaceous carcinoma and squamous cell carcinomas. The tumor clinical features varied among the different subtypes.     

Eyelid neoplasms in the Beijing Tongren Eye Centre between 1997 and 2006

BACKGROUND AND OBJECTIVE: To examine the spectrum of eyelid neoplastic specimens obtained at the Beijing Tongren Eye Centre between 1997 and 2006. PATIENTS AND METHODS: A total of 2,639 eyelid neoplasms were included in the study. RESULTS: Of the 2,639 eyelid specimens, 2,276 (86.2%) were benign and 363 (13.8%) were malignant. The most common benign lesions were inflammatory lesions, melanocytic nevi, papillomas, dermoid and epidermoid cysts, and epithelial cysts. The most common malignant or semi-malignant tumors were basal cell carcinomas, sebaceous gland carcinomas, lymphomas, squamous cell carcinomas, and malignant melanomas. The mean age at diagnosis was 41 years for benign lesions and 60 years for malignant tumors. There was no significant gender predilection among the five major non-benign eyelid tumors. CONCLUSION: At the BeijingTongren Eye Centre between 1997 and 2006, the predominant non-benign eyelid tumors were basal cell carcinoma and sebaceous gland carcinoma, followed by lymphoma. The non-benign lesions occurred predominantly in elderly patients who were 60 years of age and older.     

老年人眼肿瘤504例临床病理分析

目的：分析老年人眼部原发肿瘤的构成、分布情况及发病特点。方法：对我院病理科2000-01/2012-12收集的504例老年人眼部原发肿瘤的发病年龄、发病部位和病理类型进行回顾性分析。结果：患者504例眼部原发肿瘤中良性肿瘤346例（68.7%）,恶性肿瘤158例（31.3%）。其中良性肿瘤中以乳头状瘤最多见占83例（16.5%）,其次为各种囊肿和炎性病变分别为69例（13.7%）和64例（12.7%）。恶性肿瘤中以眼睑上皮来源的肿瘤基底细胞癌最多见,共72例（14.3%）,其次为皮肤附件来源的恶性肿瘤39例（7.7%）。从发病部位来看眼睑肿物最多282例（56.0%）,其次为眼角结膜肿物157例（31.2%）。结论：老年人眼部原发肿瘤的发病率与普通人群及儿童有明显的差异,而且随着年龄增大,恶性肿瘤比例有增高趋势。     

Survey of 447 patients with conjunctival neoplastic lesions in Farabi Eye Hospital, Tehran, Iran

PURPOSE: The current study was undertaken to determine the frequency of specific primary conjunctival neoplastic lesions in a patient population treated at an ocular service over a 15-year period. MATERIALS AND METHODS: We analyzed the data of all primary cases of conjunctival neoplasia diagnosed from 1990 to 2004 in the pathology department of Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran. RESULTS: Of 3,242 conjunctival specimens, 447 were identified as primary conjunctival neoplasms. The patient group comprised 270 (60.4%) males and 177 (39.6%) females, with an age range of 1 to 90 years. The mean age was 38 years and the median was 32 years. The most common primary conjunctival neoplastic lesion was nevus (38.7%), followed by squamous cell carcinoma, (25.1%), papilloma (7.8%), dysplasia (5.6%), and hemangioma (5.1%), respectively. Of 447 lesions, 261 (58.4%) were benign, 134 (30%) were malignant, and 52 (11.6%) were precancerous. CONCLUSION: As in previously published studies, benign lesions were the most frequent, but the percent of malignant lesions was much higher than that described in other reports. The high percentage of squamous cell carcinoma that we observed can likely be attributed to elevated sun exposure and ultraviolet light in Iran. The characterization of precancerous lesions in this study emphasizes their potential to transform into malignant lesions and the need for sufficient early management and follow up.