Department of Ophthalmology, Emory University, School of Medicine, Atlanta, Georgia, USA.
Ophthalmology. 2012 Apr;119(4):682-7. doi: 10.1016/j.ophtha.2011.09.024. Epub 2011 Dec 24.
To describe the clinical, histopathologic, immunohistochemical, and ultrastructural features of a case series of benign stromal tumors in the bulbar conjunctiva.
Observational case series.
Four patients with a conjunctival lesion that were classified histologically as low-grade stromal tumors consisting of spindle-shaped cells with occasional pseudonuclear inclusion and multinucleated cells in a partly myxoid matrix.
Four cases of low-grade conjunctival stromal tumors were retrospectively identified in an ophthalmic pathology laboratory database. Patients' records were analyzed for demographic data, clinical appearance, and the postoperative course. Formalin-fixed, paraffin-embedded specimens were routinely processed and stained with hematoxylin and eosin and periodic acid Schiff. Immunohistochemical stains for vimentin, S100, CD34, smooth muscle actin (SMA), CD68, and factor XIIIa were performed. Transmission electron microscopy (TEM) was performed on 3 of the cases.
Histopathologic evaluation (including immunostains and TEM) and clinical correlation.
All 4 tumors occurred in the bulbar conjunctiva of patients between 41 to 53 years of age. None of the patients developed recurrence after excisional biopsy. Histologically, all tumors exhibited spindle-shaped cells with pseudonuclear inclusions and occasional multinuclear cells. Mitotic figures were not observed. The stroma seemed to be myxoid to collagenous. Immunohistochemical stains were positive for CD34, vimentin, and focally for CD68, but were negative for S100 and SMA.
We propose to classify these benign lesions, which share distinct histopathologic features, as "conjunctival stromal tumors." A reactive/inflammatory component needs to be considered in the pathogenesis of this lesion.
描述球结膜良性间质瘤的临床、组织病理学、免疫组织化学和超微结构特征。
观察性病例系列。
四名患者的结膜病变组织学分类为低度间质肿瘤，由梭形细胞组成，偶尔有假核包涵体和多核细胞，部分呈黏液样基质。
在眼科病理学实验室数据库中回顾性确定了四例低度结膜间质瘤病例。分析患者的记录，以获取人口统计学数据、临床表现和术后过程。福尔马林固定、石蜡包埋标本常规处理，行苏木精和伊红及过碘酸雪夫染色。进行波形蛋白、S100、CD34、平滑肌肌动蛋白（SMA）、CD68 和因子 XIIIa 的免疫组织化学染色。对 3 例进行透射电子显微镜（TEM）检查。
组织病理学评估（包括免疫组化和 TEM）和临床相关性。
所有 4 例肿瘤均发生在年龄为 41 至 53 岁的患者的球结膜。所有患者在切除活检后均无复发。组织学上，所有肿瘤均显示出梭形细胞，具有假核包涵体和偶尔的多核细胞。未见有丝分裂象。基质似乎呈黏液样至胶原样。免疫组织化学染色 CD34、波形蛋白阳性，CD68 局灶性阳性，但 S100 和 SMA 阴性。
我们建议将这些具有独特组织病理学特征的良性病变归类为“结膜间质瘤”。该病变的发病机制需要考虑到反应性/炎症成分。
