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1 0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.
目的：探讨眼眶原发性滑膜肉瘤(synovial sarcoma，SS)的临床病理学及分子遗传学特点。方法：收集1例复旦大学附属眼耳鼻喉科医院眼科2020年10月收治并经病理学检查证实为眼眶原发性SS的病例，同时回顾性分析文献中已报道的10例眼眶原发性SS的临床及病理检查资料，包括临床表现、影像学检查、组织学特点、免疫表型及分子病理学检查结果。结果：患者女，53岁，因“复发性右眼眶内肿物13余年”收治入院。SS组织病理学：肿瘤由弥漫分布的单一短梭形细胞组成，肿瘤细胞异型性明显，胞质少，核分裂多见；肿瘤侵犯结膜下、巩膜表面、视神经鞘膜、眶内肌肉及纤维脂肪组织。免疫组织化学检查提示波形蛋白(Vimentin)、Calpolnin、CD99、Bcl-2均阳，SMARCB1(INI-1)部分阳/弱阳。荧光原位杂交(fluorescence in situ hybridization，FISH)法检测到SS18基因易位。回顾性总结文献中已报道的10例和本例(总共11例)眼眶SS患者，其中男性2例，女性9例，左眼6例，右眼5例；患者发病年龄为1~53岁，平均年龄22岁，中位年龄24岁。患者术前病程范围较广，为1周~13年。11例中，5例症状至少出现3年以上，多表现为进行性眼球突出伴眼球移位及运动受限，疼痛及视力下降。CT和MRI上多表现为分叶状或者卵圆形软组织肿块，部分因出血坏死出现囊性外观，增强扫描显示病灶呈不均匀强化。组织学上，本组11例眼眶SS中单相纤维型7例，双相型4例，单相纤维型中有2例存在分化差的成分。免疫组织化学染色显示：上皮样成分表达上皮标记(CKpan、CK7、CK19)和Vimentin；梭形细胞表达Vimentin、CD99、Bcl-2、Calpolnin、TLE1及灶性表达上皮标记。结论：眼眶原发性滑膜肉瘤罕见，形态上需要和眼眶其他软组织来源恶性肿瘤相鉴别，其具有特征性t(x:18)(p11;q11)染色体易位，产生SY T-SSX融合基因，分子病理学的检测有助于最后确诊。
Objective: To investigate the clinicopathological and molecular genetics features of synovial sarcoma (SS) of the orbit. Methods: We retrospectively reviewed 10 published cases of primary SS of the orbit, along with 1 case of primary SS of the orbit confirmed by pathology who was admitted to the ophthalmology department of Eye & ENT Hospital of Fudan University in October 2020. The clinical data, radiological findings,morphology, immunophenotype and genetic characteristics of the cases were analyzed. Results: Our case was a 53-year-old woman with an SS in the right orbit, which had recurred multiple times. Histopathologic examination showed a primitive tumor composed of spindled and ovoid cells. Focal infiltration was observed in adjacent structures, such as the sub-conjunctiva, scleral surface, optic nerve sheath, muscle, and fibro-fatty tissue. Immunohistochemistry showed positivity for vimentin, calponin, CD99, and Bcl-2 and loss of INI-1expression, which is typical of SS. Fluorescence in situ hybridization (FISH) showed the (X;18)translocation in the tumor cells. The analysis included 2 males and 9 females aged between 1 and 53 years old (mean: 22 years; median: 24 years). Among the SS cases, 6 left eyes and 5 right eyes (all monocular cases)were affected. Symptoms had been present from 1 week to 13 years in the case from our hospital, while in 5 cases, symptoms had been present for at least 3 years. Common clinical features of the patients included proptosis or globe displacement, decreased vision, and pain. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed an ovoid mass with heterogenous enhancement and a cystic appearance,which was probably attributable to hemorrhage or necrosis. Of these 11 cases, 7 cases were biphasic SS,4 were monophasic fibrous SS, and 2 were poorly differentiated in monophasic SS. Immunohistochemistry revealed positivity for pan-cytokeratin (CKpan), CK7, CK19, vimentin, cluster of differentiation 99 (CD99),B-cell lymphoma 2 (Bcl-2), calponin and transducin-like enhancer protein 1 (TLE1). Conclusion: Primary SS of the orbit is extremely rare and needs to be distinguished from other spindle cell tumors of orbital soft tissue. The SS diagnosis is based on the presence of the t(X;18) (p11; q11) translocation, which results in an SYT-SSX fusion gene.
眼球表面鳞状细胞性肿瘤是比较常见的眼表肿瘤，包括鳞状细胞乳头状瘤、日光性角化病、结膜上皮内瘤变和鳞状细胞癌。深入了解这些病变的临床和病理学特点，有利于提高临床诊断的正确性。本文对眼球表面鳞状细胞性肿瘤的类型、临床表现和病理学特点进行阐述，以期对临床诊治提供参考。
Ocular surface squamous neoplasia (OSSN) is the most common tumor of the ocular surface, including squamous cell papilloma, actinic keratosis, conjunctival intraepithelial neoplasia and squamous cell carcinoma. The extended understanding of clinicopathological features could help improve clinical accurate diagnosis of these lesions. This article reviews the classification, clinical features and pathological characteristics of OSSN to provide the reference for clinical diagnosis and treatment.
眼科病理学是系统组织病理学的重要分支，作为基础医学与临床医学之间的桥梁和纽带，对于深入认识和揭示眼部疾病的发病特点发挥着重要作用。眼科病理学在老一辈专家们的努力下奠定了坚实的基础。目前眼科病理学学科的发展随着眼科临床技术以及系统病理学的发展在不断的前进，细胞生物学及分子生物学的全方位结合和纵深应用带动并拓展了眼科病理学的研究领域，临床病理学及实验病理学的研究不断更新，新形势下眼科病理学的发展充满着机遇和挑战。
Ophthalmic pathology is an important branch of histopathology. As a bridge and link between basic medicine and clinical medicine, ophthalmic pathology plays an important role in understanding and revealing the characteristics of ocular diseases. The previous generations have laid a solid foundation for ophthalmic pathology with their hard work. Moreover, the advancement of ophthalmic clinical technology and systematic pathology in recent years have further facilitated the development of ophthalmic pathology. The comprehensive combination and in-depth application of cell biology and molecular biology have promoted and expanded the research field of ophthalmic pathology. In addition, new progress has been witnessed in the field of clinical pathology and experimentalpathology constantly. Under the new situation, the development of ophthalmic pathology is faced with both opportunities and challenges.
