泪阜部色素痣合并鳞状细胞乳头状瘤10例的临床病理学分析

Clinicopathological analysis of 10 cases of pigment nevus of lacrimal caruncle complicated with squamous cell papilloma

目的:分析泪阜部色素痣合并鳞状细胞乳头状瘤的临床及组织病理学特征。方法:选取2002年1月至2020年6月天津市眼科医院经手术切除的色素痣合并鳞状细胞乳头状瘤10例,分析患者的临床及组织病理学特征。结果:10例患者中男性5例(50%),年龄(50.20±19.57)岁,左眼5例,右眼5例,其中7例(70%)为复合痣,3例(30%)皮内痣,未见交界痣,7例复合痣和2例皮内痣可见结膜上皮细胞囊肿;鳞状细胞乳头状瘤中,有蒂型7例(70%),无蒂型3例(30%),9例(90%)含结膜杯状细胞,1例(10%)伴有鳞状上皮角化,3例(30%)伴慢性炎症,2例(20%)伴有轻度非典型增生,所有病例未见明显的弹力纤维变性。结论:泪阜部色素痣合并鳞状细胞乳头状瘤比较少见,外观易误诊为色素痣恶变或黑色素瘤,临床上应注意甄别,确诊有赖于组织病理学检查。

Objective:To analyze the clinical pathologic characteristics of pigment nevus of lacrimal caruncle complicated with squamous cell papilloma.Methods:This is retrospective case series study including ten patients diagnosed as pigment nevus of lacrimal caruncle complicated with squamous cell papilloma who underwent surgical treatment at Tianjin Eye Hospital from January 2002 to June 2020.The clinical and histological data were abstained for statistical analysis.Results:Among the included 10 patients 5(50%)were males.The mean age was 50.20±19.57 years(ranged,21 to 72 years).Five cases involved with the right eye and the other 5 cases involved with the left eye.In term of subtype of nevus,7 cases(70%)were compound nevus and the left 3 cases(30%)were intradermal nevus.The conjunctival epithelial cysts were found in 7 cases of compound nevus and 2 cases of intradermal nevus.Regarding the clinical appearance of papilloma,7 cases were pedunculated and 3 cases were sessile.There were 9 papilloma eyes containing conjunctival goblet cells,1 shows hyperkeratosis,3 with chronic inflammation,2 showed mild atypia.There was no obvious elastosis in any of the tumors.Conclusion:The pigment nevus of lacrimal caruncle complicated with squamous cell papilloma mainly localized were not common.They were easily misdiagnosed as melanoma and the diagnosis depended on histopathological examination.