Tseng S H, Chen Y T, Huang F C, Jin Y T
Department of Ophthalmology, College of Medicine, National Cheng Kung University, Tainan, Taiwan, ROC.
Ophthalmology. 1999 Aug;106(8):1516-20. doi: 10.1016/S0161-6420(99)90446-3.
Seborrheic keratosis on the conjunctiva appears to have never been reported in the literature. The authors report here a well-documented case of seborrheic keratosis of conjunctiva clinically simulating a malignant melanoma.
Case report.
A 66-year-old man presented with a juxtalimbal pigmented tumor involving the temporal conjunctiva of his left eye. Because of the rapid enlargement of the mass within a period of 5 months, a clinical diagnosis of malignant melanoma was made. Cytopathologic examinations were performed by impression cytology before the patient underwent a wide en-block excision of the tumor.
Cytologic features were studied by impression cytology with periodic acid-Schiff-Papanicolaou stain. Immunochemical characteristics of tumor cells were studied by immunochemical stain of cytokeratin and HMB-45. Tumor morphology was observed by histopathologic examination.
Impression cytology disclosed basaloid cells intermixing with squamoid cells, and these cells demonstrated positive immunoreactivity to cytokeratin and no reactivity to HMB-45. Histopathologic examination of the tumor specimen established the diagnosis of seborrheic keratosis, and the results of immunohistochemical staining were consistent with those of the impression cytology with immunocytochemical staining.
The authors describe the first case report of conjunctival seborrheic keratosis and present its immunocytochemical and immunohistochemical characteristics. Such a benign lesion can clinically mimic a malignant melanoma.
结膜脂溢性角化病在文献中似乎从未有过报道。作者在此报告一例有充分记录的结膜脂溢性角化病病例，临床上模拟恶性黑色素瘤。
病例报告。
一名66岁男性患者，左眼颞侧结膜出现一个近角膜缘色素性肿物。由于肿物在5个月内迅速增大，临床诊断为恶性黑色素瘤。在患者接受肿瘤广泛整块切除术前，通过印片细胞学进行细胞病理学检查。
采用过碘酸-希夫-巴氏染色的印片细胞学研究细胞学特征。通过细胞角蛋白和HMB-45免疫化学染色研究肿瘤细胞的免疫化学特性。通过组织病理学检查观察肿瘤形态。
印片细胞学显示基底样细胞与鳞状细胞混合，这些细胞对细胞角蛋白免疫反应阳性，对HMB-45无反应。肿瘤标本的组织病理学检查确诊为脂溢性角化病，免疫组织化学染色结果与免疫细胞化学染色的印片细胞学结果一致。
作者描述了首例结膜脂溢性角化病病例报告，并展示了其免疫细胞化学和免疫组织化学特征。这样一种良性病变在临床上可模拟恶性黑色素瘤。
