Bakri Sophie J, Carlson J Andrew, Meyer Dale R
Lions Eye Institute, Department of Ophthalmology, Albany Medical College, New York, U.S.A.
Ophthalmic Plast Reconstr Surg. 2003 Mar;19(2):162-4. doi: 10.1097/01.IOP.0000056024.60199.07.
A healthy 13-year-old female presented with a 5-month history of an enlarging red-brown, firm lower eyelid mass associated with loss of eyelashes. An excisional biopsy revealed a well-circumscribed nodule composed of coalescing nests of epithelioid cells, rare multinucleated cells, and vacuolated macrophages and spindle cells. Additional studies revealed a positive vimentin and alpha(1)-antitrypsin, and negative S100 protein and Factor XIIIa immunophenotype. This constellation of clinicopathologic features is diagnostic of solitary reticulohistiocytoma, but also shows overlap with xanthogranuloma, a common childhood histiocytosis. Reticulohistiocytoma should be considered in the differential diagnosis of eyelid tumors and has the potential for local recurrence. Diffuse cutaneous reticulohistiocytosis or multicentric reticulohistiocytosis should be considered if similar cutaneous lesions with or without symptoms of arthritis are present, respectively.
一名13岁健康女性，下眼睑出现一个红棕色、质地坚硬且不断增大的肿块，伴有睫毛脱落，病程5个月。切除活检显示有一个边界清晰的结节，由融合的上皮样细胞巢、罕见的多核细胞、空泡化巨噬细胞和梭形细胞组成。进一步检查显示波形蛋白和α1抗胰蛋白酶呈阳性，S100蛋白和因子ⅩⅢa免疫表型呈阴性。这一系列临床病理特征可诊断为孤立性网状组织细胞瘤，但也与儿童常见的组织细胞增多症——黄色肉芽肿有重叠。在眼睑肿瘤的鉴别诊断中应考虑网状组织细胞瘤，且有局部复发的可能。如果分别出现伴有或不伴有关节炎症状的类似皮肤病变，则应考虑弥漫性皮肤网状组织细胞瘤或多中心网状组织细胞瘤。
