眼部嗜酸细胞腺瘤的临床表现及病理特点

The Clinical and Pathologic Character of Ocular Oxyphilic Adenoma

目的探讨眼部嗜酸细胞腺瘤的临床诊断，以提高诊断准确性。方法回顾性分析经病理学及免疫组化证实的6例眼部嗜酸细胞腺瘤患者的临床及病理学资料。结果（1）临床表现：除1例眼球轻度突出外，多数患者无明显症状，偶有异物感、流泪、眼红痛等不适。病变全部单发，其中泪阜3例，泪囊、泪腺及睑结膜各1例。2例经CT检查，1例显示右眼泪阜区域一高密度病灶；1例显示眶外上方泪腺区一卵圆形高密度影；后者行眼B超探查显示眶外上方一卵圆形较强回声团。（2）病理学特征：肿块多为圆形或卯圆形，表面光滑，直径1～4cm不等。肿物包膜完整，切面呈棕红色或灰红色，1例伴有小囊腔，内含褐色液体。肿块全埋制片，HE染色，光镜下显示组织学形态较一致，主要由体积较大的嗜酸细胞组成，排列成巢状或呈腺样结构。以腺样结构为主者瘤细胞圆形或柱状，胞浆丰富，嗜酸颗粒异常清楚，核圆或椭圆，小而深染，核仁不明显，未见分裂象。（3）免疫表型：免疫组化（LSAB法）染色显示EMA在胞质和胞膜强表达，而S-100及vimentin均未见阳性表达。结论眼部嗜酸细胞腺瘤临床症状不明显，病理学及免疫组化检查有助于诊断及鉴别诊断。

Objective To investigate the clinical and pathologic character of ocular oxyphilic adenoma in order to improve the accuracy of the diagnosis.Method Retrospectively analyze the clinical and pathologic data of six ocular oxyphilic adenoma patients which are proved by pathology and immunohistochemistrdon.Result （ 1 ）Clinical manifestation：Most patients don＇t have overt symptom.There is only some feeling of foreign body sensation, lacrimation and ocular erythralgia now and then except one patient had light exophthalmos.All patients are singly happened, including three cases of lacrimal caruncles, one dacryocyst, one lacrimal gland and one palpebral conjunctiva.Most lumps are round or orbicular-ovate, slick and their diameters are from 1 to 4 mm. （2）Pathologic character：The lumps have complete amiculas and their cross sections are brownish red or gray red.One case has small capsular space which are filled with brown liquid.The lumps are completely buried to slice and dyeing with HE.Histology shapes are fairly concord by light microscope.The lumps are composed by larger acidocyte which arrange like nest and gland.The glandish neoplastic cell are round or prismatical, plent of endochylema; acidophil granule are exceptionaly distinct; nuclear are round and ellipse, small and anachromasis; chromatospherite are not obvious and no mitotic figure is found. （3）Immunophenotype： EMA have strong expression in kytoplasm and cell membrane but S-100 and vimentin do not have expression by immunohistochemistry （LSAB）dyeing.Conclusion Ocular oxyphilic adenoma is lack of special clinical signs, Pathologic and immunohistochemistry examination can help to its diagnosis and antidiastole.