结膜原发性肿块422例的临床病理探讨

Clinical pathological analysis of 422 primary conjunctival masses

摘要:

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。

Abstract:

AIM: To improve accuracy of the diagnosis of primary conjunctival masses(PCM)through analyze the clinicopathological characteristics and pathogenic causes of 422 cases of PCM.

METHODS: Clinical manifestations, histological characteristics and immunopheno types were reviewed. Relevant literatures were reviewed.

RESULTS: Benign conjunctival masses were 403 cases(95.5%). Those included masses from squamous cell papilloma(71 cases, 17.6%), conjunctival cyst(68 cases, 16.9%), inflammatory masses(62 cases, 15.4%), pigmented nevus(60 cases, 14.9%), lipoma(58 cases, 14.4%). Malignant conjunctival neoplasms were 19 cases(4.5%). Those included tumors from B Cell Lymphoma(6 cases,31.6%), melanoma(6 cases,31.6%), and squamous cell carcinoma(5 cases, 26.3%). Different types of primary conjunctival masses were induced by the same cause.

CONCLUSION:The pathological types of primary conjunctival masses are various and the majority of which is benign. For the diagnosis of primary conjunctival masses, morphological analysis, immunohistochemical examination shoud be combined to increase the diagnostic accuracy and decrease misdiagnosis rate.