眼睑无色素性黑色素瘤伪装成霰粒肿1例

A case of amelanotic melanoma of the eyelid masquerade as chalazion

报道一例发生在41岁中年女性左眼上睑的无色素性黑色素瘤,曾在当地医院误诊为霰粒肿。体检见左眼上睑结膜面一大小约2 cm×2 cm红色肿物,手术切除肿物送病理检查,标本经10%福尔马林固定,常规石蜡包埋切片,HE染色及免疫组织化学染色。光镜下见肿瘤细胞呈片状及巢状排列,瘤细胞圆形及梭形,部分瘤细胞胞浆空泡状呈气球样形,部分细胞核仁明显。免疫组化显示肿瘤细胞S-100、HMB-45阳性,CK及EMA阴性,最终病理诊断为左眼上睑无色素性黑色素瘤。对于临床上患者年龄较大无典型霰粒肿特征的眼睑肿物,术后标本均应送病理检查以除外其它肿瘤的可能。

To report a case of amelanotic melanoma located in the left upper eyelid misdiagnosed as chalazion in a 41-year- old woman. Examination showed a red 2 cm x 2 cm mass in the left upper palpebral conjunctiva. The tumor was excised and regular fixed in 10% formalin, embedded, sectioned, HE stained and immunohistochemistry stained. Histopathological examination revealed nests of round atypical tumor cells with vacuolated cytoplasm and sheets of spindle atypical tumor cells. Some tumor cells had conspicuous nucleoli. Immunohistochemistry some tumor cells were positive for melanocytic markers S-100, HMB-45 and negative for CK, EMA. So the pathological diagnosis was palpebral conjunctiva amelanotic melanoma in the left upper eyelid. For the mass in palpebral conjunctiva of senile patients without typical characteristics of chalazion, the surgical specimen should be performed for pathologic examination to rule out other tumors.