目的： 探讨EZ Prep清洗液替代二甲苯进行手工脱蜡制作特殊染色片的效果。 方法: 应用EZ Prep清洗液替代二甲苯脱蜡，选取中山大学中山眼科中心临床病理科石蜡标本100例进行回顾性研究，常规切片后切片一式两份，分别采用传统二甲苯和EZ Prep清洗液手工脱蜡后按实验室标准化操作流程进行特殊染色，并比较脱蜡时间和染色效果。 结果： EZ Prep清洗液手工脱蜡处理的切片在革兰氏染色(Gram's)、六胺银染色(GMS)、高碘酸-无色品红染色(PAS)、马松(Masson)三色染色、刚果红等多种特殊染色中的染色质量和二甲苯脱蜡处理的效果一致，两组间优良率比较差异无统计学意义(χ 2 = 0. 33，P ＞ 0. 05)，且平均脱蜡时间由(33.0±2.7)min缩短至(7.2±1.1)min，加快了染色出片时间。结论：EZ Prep清洗液可以替代二甲苯在眼组织特殊染色中脱蜡，并具有脱蜡时间短、环保的优点，值得推广应用。
Objective: To investigate the effect of EZ Prep cleaning solution as an alternative to xylene for manual deparaffinization in the preparation of special staining slides. Methods: EZ Prep cleaning solution was utilized to replace xylene for deparaffinization in a retrospective study involving 100 paraffin-embedded specimens from the Clinical Pathology Department of Zhongshan Ophthalmic Center, Sun Yat-sen University. Routine sections were prepared and duplicated, with one set deparaffinized using traditional xylene and the other using EZ Prep cleaning solution. Subsequent special staining was performed following standardized laboratory protocols. Deparaffinization time and staining outcomes were compared. Results: Slides treated with EZ Prep cleaning solution for manual deparaffinization demonstrated staining quality comparable to xylene treatment across various special stains, including Gram's, GMS, PAS, Masson's trichrome, and Congo red. The difference in the excellent rate between the two methods is not statistically significant (χ 2 = 0.33, P > 0.05). Moreover, the average deparaffinization time is significantly reduced from 33.0±2.7 minutes to 7.2±1.1 minutes, thereby speeding up the staining process. Conclusion: EZ Prep could replace xylene deparaffinized sections in special staining of ocular tissues with the advantages of shorter deparaffinized time and environmental protection, which is worthy of promotion and application.
髓上皮瘤是源自神经系统的一种少见的恶性肿瘤, 多发生在中枢神经系统和睫状体,而源自视神经的恶性髓上皮瘤则很少见, 国内尚未有病例报道。此病早期类似胶质瘤, 易造成误诊。本文报道了 1 例 3 岁 10 个月的男性患儿, 经部分肿物切除活检发现肿瘤具有典型恶性髓上皮瘤的病理特点, 部分瘤细胞向软骨细胞分化, 并逐渐形成透明软骨岛, NSE 及 S-100 表达阳性, 病理诊断为源自视神经的畸胎性恶性髓上皮瘤。
Medulloepithelioma is a clinically uncommon tumor originated from nervous system, often occurred in central nerve system and ciliary body, and malignant medulloepithelioma of the optic nerve is far rarer. So far, there has been no case report in China. It may be clinically misdiagnosed because it resembles glioma at the early stage of the disease. We reported a boy with a tumor in his right eye at age of 3.8 years, which was shown by biopsy of the partial tumor that there were some obviously heteromorphous neoplastic cells, karyokinesis, and moreover, some neoplastic cells differentiatied into cartilage cells, gradually formed into hyaline cartilage islands and the expressions of NSE and S-100 were positive. Teratoid malignant medulloepithelioma of optic nerve was made pathologically.
玻璃体淀粉样变性是一种罕见的眼病, 可独立发病, 也可以表现为系统性淀粉样变性的眼部受累, 常有家族史。报道 1 例遗传性玻璃体淀粉样变性患者, 中年发病, 双眼先后受累,有明确的家族史。双眼均行玻璃体切除术。术后病理检查结果显示: 玻璃体呈刚果红染色阳性, 电镜下发现纤维丝状物。对患者外周血进行 DNA 抽提, PCR 扩增, 克隆、筛选及测序等一系列基因检测, 发现转甲蛋白(Transthyretin, TTR) 存在着基因突变, 突变点 Gly83Arg, 这可能是玻璃体淀粉样变性发病的一个新的突变位点。
Vitreous amyloidosis is a rare condition that mainly occurs in Familial Amyloidotic Polyneuropathy (FAP). In some cases, it may be the only symptom without systemic disorders. One case of familial vitreous amyloidosis was reported here, with white, wispy opacities in vitreous cavity in both eyes. Pars plana vitrectomy and histopathological examination of the vitreous specimens were performed. The vitreous specimens showed typical microscopic features of amyloidosis with Congo red stain and non-branching fibrils on a transmission electron microscope. Transthyretin (TTR) gene was amplified with DNA isolated from the peripheral blood cells. Bi-directional sequencing of exon 3 showed a single base-pair substitution, which results in an amino acid substitution at position83, glycine to arginine (TTR Arg-83) . TTR Arg-83 may be a new pathologic mutation in vitreous amyloidosis.
目的：探讨眼眶黏膜相关淋巴组织(mucosa-associated lymphoid tissue，MALT)结外边缘区B细胞淋巴瘤的临床表现、影像学特征及病理学特点，以期减少眼眶淋巴瘤的误诊，提高生存率。方法：对2020年1月至2020年12月中山大学中山眼科中心诊治的71例眼眶MALT结外边缘区B细胞淋巴瘤的临床、影像及病理学资料进行回顾性分析。结果：71例患者中，男38例，女33例；左侧眼眶31例，右侧眼眶34例，双侧眼眶6例；原发病例67例，复发病例4例；年龄23~84岁，病程为3个月~15年。最常见的临床表现是眼部肿块和不同程度的眼球活动受限；磁共振成像(magnetic resonance imaging，MRI)检查见密度均匀的软组织影，呈“铸造样”，眼球内未见侵犯；组织病理检查可见肿瘤由小至中等大小淋巴样细胞组成，瘤细胞呈弥漫或片状生长，核小到中等、不规则，核仁不明显，部分细胞呈单核样淋巴瘤细胞改变，其中9例可见浆细胞样分化，伴浆细胞分化的病例kappa与lambda的表达不对称。结论：眼眶MALT结外边缘区B细胞淋巴瘤有多种临床表现，影像学检查具有一定的特征，可辅助术前诊断。病理学检查可用于术后的准确诊断及分型，据此制定合适的治疗方案，提高疗效。
Objective: To investigate the clinical, imaging and pathological features of orbital extranodal marginal zone B cell lymphoma of mucosa-associated lymphoid tissue (MALT), so as to reduce misdiagnosis and improve survival rate.Methods: The clinical, imaging and histopathological data of 71 patients with orbital extranodal marginal zone B cell lymphoma of MALT who were treated in Zhongshan Ophthalmic Center, Sun Yat-sen University from Jan.2020 to Dec. 2020 were retrospectively analyzed. Results: There were 38 males and 33 females in the 71 patients.There were 31 cases located on the left orbit, 34 cases on the right orbit, and 6 cases were bilateral; there were 67 primary cases and 4 relapsed cases. The age ranged from 23 to 84 years old. The disease course ranged from 3 months to 15 years. The main clinical manifestations included ocular masses and limited eyeball movement.Magnetic resonance imaging showed a “cast-like” soft tissue shadow of uniform density, and no intraocular invasion is observed. Histopathological examination showed that the tumor was composed of small to medium sized lymphocyte-like cells. Tumor cells exhibited diffuse or lamellar growth, with small to medium-sized irregular nuclei, and the nucleoli were inconspicuous. Some of the lymphocyte-like cells showed mononuclear lymphoma cells changes, and plasmacytoid differentiation was observed in 9 cases, in which kappa and lambda expressions were asymmetric.Conclusion: The clinical manifestations of orbital extranodal marginal zone B cell lymphoma of MALT are various, and imaging examination has certain characteristics, which can assist preoperative diagnosis.Pathological examination can be used for accurate diagnosis and classification after operation, based on which appropriate treatment plan can be made and curative effect can be improved.
眼内淋巴瘤(intraocular lymphoma，IOL)比较罕见。按起源位置分为两种类型，主要类型为原发性眼内淋巴瘤(primary intraocular lymphoma，PIOL)，也称为原发性中枢神经系统淋巴瘤(primary central nervous system lymphoma，PCNSL)；另外一种类型为继发性眼内淋巴瘤(secondary intraocular lymphoma，SIOL)，为中枢神经系统以外的淋巴瘤转移至眼内。按肿瘤类型主要分为三类，主要类型为眼内弥漫大B细胞淋巴瘤，属于高级别淋巴瘤，预后较差；其次为少见的主要侵犯脉络膜的黏膜相关淋巴组织结外边缘区B细胞淋巴瘤，属于低级别淋巴瘤，预后较好；第三种类型为极少见的眼内NK/T细胞淋巴瘤，属于高级别淋巴瘤，预后极差。该病的诊断对眼科医生和病理医生都极具挑战性。实验室检测方法主要包括病理学、免疫细胞化学、流式细胞术、细胞因子及基因重排等，但眼内病理活检仍然是该病诊断的金标准。该病的治疗主要为眼内局部化疗、放射治疗及系统性化疗。IOL早期常因误诊而耽误治疗，目前该病明确诊断时多在患者出现症状后4~40个月，多数病例早期被误诊为葡萄膜炎而失去治疗的最佳时机，导致预后较差。因此应充分认识IOL的早期表现，早期诊断、早期治疗，从而大大提高疗效。
Intraocular lymphomas (IOL) are rare malignant neoplasms including primary intraocular lymphoma (PIOL) and secondary intraocular lymphoma (SIOL). The former is also known as primary central nervous system lymphoma(PCNSL). The latter is a kind of lymphoma metastasizing to the eye from outside the central nervous system. IOL can further be divided into three different types. The most common type is vitreoretinal high-grade diffuse large B-cell lymphoma with poor prognosis. The less common type is primary choroidal extranodal marginal zone B-cell lymphoma of mucosa associated lymphoid tissue, which is low-grade B-cell lymphoma with better prognosis.The rare type is NK/T cell lymphomas with very poor prognosis. The diagnosis of this disease is challenging for both ophthalmologists and pathologists. Laboratory testing methods mainly include cytology/pathology,immunocytochemistry, flow cytometry, cytokine analysis and gene rearrangement detection. The detection of malignant lymphoid cells cytologically/pathologically is still the gold standard for diagnosing IOL. The treatment involves local chemotherapy, radiotherapy and systemic chemotherapy. Most intraocular lymphomas at early stage are misdiagnosed as uveitis and proper treatment is often delayed with poor diagnosis due to the lost of best time for treatment. So far, the delay between the diagnosis and the onset of ocular symptoms ranges from 4 to 40 months. Therefore, we should fully understand the early manifestations of intraocular lymphoma and early diagnose and timely treat the disease in order to improve prognosis.
目的：探索用细胞块制备试剂盒对眼内玻璃体液微量细胞制备细胞块的成功率，苏木素-伊红(hematoxylin-eosin，HE)染色效果及技术要点。方法：收集中山大学中山眼科中心临床病理科2020年9月至2021年1月由临床送检的25例玻璃体液(含玻璃体切割液)，应用细胞块制备试剂盒制备细胞块后，常规固定、脱水、包埋、切片，随后进行HE染色，观察染色效果。结果：25例玻璃体细胞蜡块制作成功率达到100%，制片后HE染色效果好，背景干净，细胞形态清晰，核质对比分明。结论：应用细胞块制备试剂盒能将眼内玻璃体液微量细胞制成蜡块，极大提高了标本的利用率，为后续的病理研究提供丰富的材料。
Objective: To explore the effect and technical key points of the cell block preparation kit for collecting a few cells in ocular vitreous humor. Methods: A total of 25 cases of vitreous humor (including vitrectomy fluid) were collected from Zhongshan Ophthalmic Center, Sun Yat-sen University from September 2020 to January 2021.Cell block preparation kit was used to prepare cell blocks, which were routinely fixed, dehydrated, embedded,sectioned, and then hematoxylin-eosin (HE) stained. Results: The success rate of 25 cases of vitreous cell paraffinblocks reached 100%, and the morphology of the cells was clear with clean background and shape contrast of nucleus and plasma in HE staining. Conclusion: The cell block preparation kit can make the cells of intraocular vitreous humor into paraffin blocks, which greatly improves the utilization rate of specimens and is conducive to providing abundant materials for pathological studies.
睫状体髓上皮瘤是一种源自神经上皮层的恶性肿瘤，易因其伪装特性而被漏诊和误诊。本文报道了1例3岁9个月的男性患儿，眼部表现似晶状体破裂，经部分肿物切除活检，病理诊断为睫状体恶性髓上皮瘤。
Medulloepithelioma of the ciliary body is a kind of malignant tumor which arises from neuroepithelium. It is easily misdiagnosed or miss diagnosed due to its masquerade feature in the clinical practice. We report a boy with a tumor in his right eye at age of 3 years and 9 months presented first with lens rupture. Diagnosis of malignant medulloepithelioma of ciliary body was made pathologically by biopsy of the partial tumor.
睫状体髓上皮瘤是一种源自神经上皮层的恶性肿瘤，易因其伪装特性而被漏诊和误诊。本文报道了1例3岁9个月的男性患儿，眼部表现似晶状体破裂，经部分肿物切除活检，病理诊断为睫状体恶性髓上皮瘤。
Medulloepithelioma of the ciliary body is a kind of malignant tumor which arises from neuroepithelium. It is easily misdiagnosed or miss diagnosed due to its masquerade feature in the clinical practice. We report a boy with a tumor in his right eye at age of 3 years and 9 months presented first with lens rupture. Diagnosis of malignant medulloepithelioma of ciliary body was made pathologically by biopsy of the partial tumor.
