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 leff upper eyelid misdiagnosed as chalazion in a 41-yearold woman. Examination showed a red 2 cm × 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 leff 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.
目的:探讨爱先蓝(Alcian Blue,AB)和细胞角蛋白(cytokeratin,CK)双重染色技术在泪腺腺样囊性癌组织中的应用, 提高泪腺腺样囊性癌染色效率。方法:选取中山大学中山眼科中心临床病理科2015年1月至2017年1月期间诊断为泪腺腺样囊性癌病例标本23例,在同一张切片上先进行AB染色,再进行CK染色,观察染色效果。结果:23例泪腺腺样囊性癌标本组织中黏液物质全部呈蓝色;癌细胞胞质CK阳性,呈棕黄色。结论:AB和CK双重染色方法稳定,颜色对比鲜明,能够良好显示癌细胞及黏液的关系,并且比分开的两次单种染色省时、经济。
Objective: To investigate the application of Alcian Blue (AB) and cytokeratin (CK) double staining technique in adenoid cystic carcinoma to improve the staining efficiency. Methods: Twenty-three specimens of adenoid cystic carcinoma from January 2015 to January 2017 in the Clinical Pathology Department of Zhongshan Ophthalmic Center, Sun Yat-sen University were stained with AB first and CK then on the same slide. Results: Mucinous substance showed blue. And the cytoplasm of the cancer cells presented with brown yellow in all the specimens.Conclusion: The method of double staining with AB and CK is stable and displays bright color contrast. It can effectively reveal the relationship between the mucus and cancer cells. It proves to be more time-saving and economical than the individual staining of AB and CK respectively.