白色的隆凸：来自于皮脂腺导管的角化囊肿的标志。
The white caruncle: sign of a keratinous cyst arising from a sebaceous gland duct.
机构信息
Department of Ophthalmology, David G. Cogan Laboratory of Ophthalmic Pathology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA.
出版信息
Cornea. 2010 Apr;29(4):453-5. doi: 10.1097/ICO.0b013e3181b55b5c.
PURPOSE
To describe an acquired, smooth white lesion of the caruncle and to underscore the role of subsurface keratinizing squamous epithelium in its formation.
METHODS
Clinical photographic documentation, histopathologic evaluation, and immunohistochemical staining of an excised specimen from a 25-year-old woman.
RESULTS
A cyst was found that was lined by keratinizing squamous epithelium without a keratohyaline layer (trichilemmal keratinization), typical of lesions of the pilosebaceous unit. A portion of the cyst's lining was replaced by granulomatous inflammation resulting from an earlier spontaneous partial rupture. Ki-67 immunolabeling demonstrated relatively few nuclei in S-phase (DNA synthesis) in comparison with the overlying epithelium, thereby suggesting an obstructive, nonproliferative cause for the cyst.
CONCLUSION
A white caruncular lesion is a very rare finding according to the literature. It is most likely caused by a cyst lined by squamous epithelium elaborating trichilemmal-type keratin. A sebaceous gland duct was established as the source for the current lesion.
目的
描述一种获得性、光滑的白色结膜病变，并强调其形成过程中位于表面下的角化鳞状上皮的作用。
方法
对一名 25 岁女性的切除标本进行临床摄影记录、组织病理学评估和免疫组织化学染色。
结果
发现一个囊腔，内衬角化鳞状上皮，无角蛋白层（毛母质角化），这是毛发皮脂腺单元病变的典型特征。囊腔的一部分内衬被先前自发性部分破裂引起的肉芽肿性炎症所取代。Ki-67 免疫标记显示 S 期（DNA 合成）的细胞核相对较少，与上覆上皮相比，这表明囊肿的形成是阻塞性的、非增殖性的。
结论
根据文献，白色的结膜病变是一种非常罕见的发现。它最有可能是由鳞状上皮形成的囊内衬产生的毛母质型角蛋白引起的。当前病变的来源被确定为皮脂腺导管。
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