脉络膜血管瘤临床病理分析

目的：探讨脉络膜血管瘤临床、病理及免疫组织化学改变。方法：回顾分析8例病理诊断为脉络膜血管瘤的临床和病理资料，并对其中7例眼球标本行VEGF、CD34等免疫组织化学检查。结果：摘除眼球前2例误诊为恶性脉络膜黑色素瘤，2例拟诊脉络膜血管瘤，4例脉络膜肿物性质待查，其中5例合并新生因管性青光眼，全部伴渗出性视网膜脱离。病理证实为脉络膜海绵状血管瘤，其间被纤维结缔组织分隔，5例瘤体表面见视网膜色素上皮细胞脱失及2例视网膜下见成簇状含有色素的巨噬细胞。免疫组织化学检查：脉络膜血管瘤内皮细胞CD34均呈强阳性，而VEGF阴性表达，2例见个别细胞呈弱阳性。结论：病史较长，各种检查提示有脉络膜肿物，伴视网膜脱离的继发性青光眼患者，应高度怀疑脉络膜血管瘤。免疫组织化学显示脉络膜血管瘤是毛细血管内皮细胞源性的良性肿瘤。

Clinical pathological analysis of choroidal hemangioma

Objective: To investigate the clinical pathological and immunohistochemical features of choroidal hemangioma (CH). Methods: Eight cases of CH diagnosed pathologically were analyzed retrospectively, and in 7 specimens the expressions of VEGF and CD34 were studied with immunohistochemistry. Results: Before the enucleation, two of them were misdiagnosed as choroidal melanoma, 4 as choroidal tumors with unknown causes and 2 as CH. All were complicated with exudative retinal detachments, and five with secondary glaucoma. Pathological reports shown that the vascular pattern consisted of dilated blood channels separated by connective tissue. Loss of retinal pigment epithelium was seen on the surface of the tumors in 5 cases, and two with small clumps of macrophages containing melanin in the subretinal space. CD34 expressed strong positive in membrane and cytoplasm of endothelia of CH. And VEGF expressed negative, but weak positive in some of the endothelia. Conclusions: Patients with long-history, choroidal tumor, exudative retinal detachment and secondary glaucoma may be CH. Immunohistochemistry showed that CH was benign tumor originating from capillary.