David G. Cogan Laboratory of Ophthalmic Pathology, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston, MA 02114, USA.
Cornea. 2013 Apr;32(4):513-6. doi: 10.1097/ICO.0b013e31827932f3.
To describe an acquired keratinizing cyst of the palpebral conjunctiva.
Observational case report with clinical and histopathologic correlations.
A 41-year-old man presented with diffuse mild left upper eyelid swelling, eye pain, and redness in the absence of a nodule. Eversion of the eyelid revealed a whitish-gray, well-demarcated, superficial 4 × 4 mm lesion on the medial portion of the palpebral surface accompanied by a large epithelial erosion in the superior aspect of the cornea. The lesion was excised completely, sparing the tarsus. The site of excision healed completely after 1 week with no recurrence during 6 months of follow-up. Histopathologically, the lesion consisted of a round, eosinophilic, compact, acellular mass of keratin. The cyst's epithelial covering was a mixture of mostly flattened but occasionally polygonal basaloid epithelial cells, sometimes with foci of parakeratosis and pigmentation. There was no apparent keratohyalin granular layer (trichilemmal rather than epidermoid keratinization).
The pathogenesis of this peculiar lesion is hypothesized to involve a pseudogland of Henle that developed trichilemmal keratinization. It represents another easily overlooked cause of corneal epithelial erosion.
描述一种获得性的睑结膜角化囊肿。
观察性病例报告，结合临床和组织病理学相关性分析。
一名 41 岁男性，表现为弥漫性轻度左上眼睑肿胀、眼痛和发红，无结节。翻转眼睑发现，在睑结膜的内侧部分有一个灰白色、界限清楚、浅表的 4×4mm 病变，伴有角膜上部的一个大上皮糜烂。病变完全切除，保留了眼轮匝肌。切除部位在 1 周后完全愈合，6 个月的随访期间无复发。组织病理学上，病变由一个圆形、嗜酸性、致密、无细胞的角化团块组成。囊肿的上皮覆盖物是由大多数扁平但偶尔呈多边形基底样上皮细胞组成的混合物，有时伴有角化不全和色素沉着。没有明显的角质透明颗粒层（毛母质角化而非表皮角化）。
该特殊病变的发病机制被假设为涉及 Henle 假腺，其发展为毛母质角化。它代表了另一种容易被忽视的角膜上皮糜烂的原因。
