目的：分析结膜淋巴管扩张症(CL)的病理学特征、免疫表型及影像学表现，明确其组织起源，探索可能的病因机制，为临床诊断与治疗提供理论依据。

方法：本研究为单中心、描述性横断面研究，纳入2023年2月至2025年9月在我院接受手术治疗的CL患者的术后标本，并进行常规HE染色及免疫组织化学染色(D2-40、CD31、CD34、CK)，使用眼前节相干光断层扫描(AS-OCT)观察病变的形态。结合临床资料，对病理结果进行综合分析。

结果：共纳入CL患者32例32眼的术后标本，其中女23例(72%)，男9例(28%)，平均年龄53.03±12.47岁。所有患者均表现为球结膜下单发或多发透明囊性隆起，术后病理表现为结膜下淋巴管扩张，管腔由单层扁平内皮细胞衬里，伴随周围固有层水肿及炎症浸润。所有患者D2-40均阳性，证实为淋巴管起源； 部分病例同时存在CD31与CD34的表达。AS-OCT显示病变为单房或多房性低反射囊腔。手术完整切除后平均随访16.2 mo无复发。

结论：CL是一种以淋巴管扩张为特征的良性眼表病变，其内皮同时表达淋巴管与部分血管标记物，提示其可能属于脉管畸形谱系。AS-OCT对诊断有辅助价值，手术切除疗效确切。

METHODS:This single-center descriptive cross-sectional study enrolled postoperative specimens from patients with CL who underwent surgical treatment in the hospital between Feb. 2023 and Sept. 2025. Routine hematoxylin and eosin(HE)staining and immunohistochemical staining(D2-40, CD31, CD34, CK)were performed. Anterior segment optical coherence tomography(AS-OCT)was used to observe the lesion morphology. The pathological results were comprehensively analyzed combined with clinical data.

RESULTS: A total of postoperative specimens from 32 eyes of 32 patients with CL were enrolled, including 23 females(72%)and 9 males(28%), with a mean age of 53.03±12.47 y. All patients presented with single or multiple transparent cystic elevations beneath the bulbar conjunctiva. The postoperative pathological manifestations were characterized by dilation of conjunctival lymphatic vessels lined with a single layer of flattened endothelial cells, accompanied by edema and inflammatory infiltration in the surrounding stroma. All cases were positive for D2-40, confirming a lymphatic origin; some cases also expressed CD31 and CD34. AS-OCT revealed the lesions as unilocular or multilocular cystic spaces with low reflectivity. After complete surgical resection, the mean follow-up period was 16.2 mo with no recurrence.

CONCLUSION:CL is a benign ocular surface lesion characterized by lymphatic vessel dilation. The endothelium co-expresses lymphatic and some vascular markers, suggesting that CL may belong to the spectrum of vascular malformations. AS-OCT has adjunctive diagnostic value, and surgical resection has definitive therapeutic efficacy.