Bruns D E, Boskey A L, Lieb W, Conway B P, Savory J, Wills M R
Department of Pathology, University of Virginia School of Medicine, Charlottesville 22908.
Clin Chem. 1989 Jan;35(1):183-5.
We recently described (Arch Ophthalmol 1988; 106:725-6) the presence of unique calcific lesions in the eyelids of a young woman with a history of hyperphosphatemic tumoral calcinosis. Here we document that no immediate family members showed similar lesions and that none was hyperphosphatemic. Dental roentgenography revealed characteristic abnormalities in the patient that confirmed the clinical diagnosis of tumoral calcinosis. Seasonal biochemical studies demonstrated persistently increased concentrations of phosphorus and 1,25-dihydroxyvitamin D in her serum. A calcific eyelid excrescence removed from the patient, studied by x-ray diffraction, was found to consist of crystals of hydroxyapatite. Microprobe analysis indicated the major elements in the deposit to be Ca, P, S, and Cl, just as in the periarticular deposits found in tumoral calcinosis. The Ca concentration in the patient's tear fluid, measured by atomic absorption spectrometry, was within the range found in tears of healthy volunteers. Phosphorus was undetectable (less than 30 mumol/L) in tears of the patient and the volunteers. These findings suggest that the eyelid lesions represent a new manifestation of the pathological process that produces the characteristic periarticular calcific masses of tumoral calcinosis.
我们最近报道了（《眼科学文献》1988年；106卷：725 - 726页）一名有高磷血症性肿瘤性钙化病史的年轻女性眼睑出现独特的钙化病变。在此我们证明，其直系亲属均未出现类似病变，且无一人有高磷血症。牙科X线摄影显示该患者有特征性异常，证实了肿瘤性钙化的临床诊断。季节性生化研究表明，她血清中的磷和1,25 - 二羟维生素D浓度持续升高。通过X射线衍射研究从该患者身上切除的钙化眼睑赘生物，发现其由羟基磷灰石晶体组成。微探针分析表明沉积物中的主要元素为钙、磷、硫和氯，与肿瘤性钙化中关节周围沉积物中的元素相同。通过原子吸收光谱法测量，该患者泪液中的钙浓度在健康志愿者泪液的浓度范围内。在该患者和志愿者的泪液中均未检测到磷（低于30 μmol/L）。这些发现表明，眼睑病变代表了产生肿瘤性钙化特征性关节周围钙化肿块的病理过程的一种新表现。
