Vervaet N, Van Ginderdeuren R, Van Den Oord J J, Foets B
Department of Ophthalmology, UZ Leuven, Leuven, Belgium.
Bull Soc Belge Ophtalmol. 2007(303):63-7.
A conjunctival Spitz nevus is a very rare, benign melanocytic lesion, which can be mistaken for a malignant melanoma. We present a case of a 28-year old man, who suffered from a rapidly growing, non-pigmented mass in the left caruncular area, extending to the nasal conjunctiva. The lesion was excised and pathologic examination showed nests of large, polygonal, non-pigmented epithelioid cells, located in the stroma. The overlying epithelium showed focal erosions. At the base, there was a lymphocytic infiltrate. Immunohistochemical techniques, with stainings for S-100 protein, HMB-45 and MIB-1, were used for further investigation and showed the melanocytic origin of the lesion (S-100 staining) as well as many cells in cell cycle (MIB-1 staining). However, no mitoses were seen. The clinical image, combined with pathologic and immunohistochemical findings, provided the diagnosis of a Spitz nevus localised in the conjunctiva. Although the cutaneous location of Spitz nevi is well known, conjunctival Spitz nevi are very rare and because of their mucosal origin, some of the histological features are different.
结膜斯皮茨痣是一种非常罕见的良性黑素细胞病变，可被误诊为恶性黑色素瘤。我们报告一例28岁男性患者，其左泪阜区有一迅速生长的无色素肿物，并延伸至鼻侧结膜。该病变被切除，病理检查显示在间质中有巢状大的、多边形的、无色素的上皮样细胞。覆盖的上皮有局灶性糜烂。在基部有淋巴细胞浸润。采用免疫组织化学技术，用S-100蛋白、HMB-45和MIB-1染色进行进一步研究，显示病变的黑素细胞起源（S-100染色）以及处于细胞周期的许多细胞（MIB-1染色）。然而，未见有丝分裂。临床图像结合病理和免疫组织化学结果，诊断为位于结膜的斯皮茨痣。虽然斯皮茨痣的皮肤部位很常见，但结膜斯皮茨痣非常罕见，并且由于其黏膜起源，一些组织学特征有所不同。
