Folberg R, Jakobiec F A, Bernardino V B, Iwamoto T
Department of Ophthalmology, University of Iowa, Iowa City 52242.
Ophthalmology. 1989 Apr;96(4):436-61. doi: 10.1016/s0161-6420(89)32878-8.
The common acquired conjunctival nevus usually undergoes progressive maturation and only exceptionally gives rise to conjunctival melanoma. Pure junctional nevi are rare except in childhood. Histologically, however, a junctional nevus may be indistinguishable from primary acquired melanosis (PAM) with atypia, a condition of middle-aged and elderly individuals that has a tendency to evolve into melanoma. Nevi in adolescents may attract a vigorous lymphocytic response and may cause clinical and histologic confusion with other entities, particularly a regressing nodule of melanoma that occurs predominantly in adults. Rarely, congenital conjunctival nevi are identified, sometimes in patients with adjacent congenital nevi of the eyelid. A variety of unusual nevi, including balloon-cell nevi, Spitz nevi, epithelioid cell nevi, dysplastic nevi, recurrent nevi, episcleral melanosis and the nevus of Ota, blue and cellular blue nevi, melanocytoma, and composite or mixed nevi all may be identified in the conjunctiva. Concepts of histogenesis as well as the clinical, light microscopic, and ultrastructural features of these and other benign pigmentary conditions of the conjunctiva are described.
常见的获得性结膜痣通常会逐渐成熟，只有极少数情况下会发展为结膜黑色素瘤。纯交界痣很少见，儿童期除外。然而，在组织学上，交界痣可能与伴有异型性的原发性获得性黑色素沉着症（PAM）难以区分，PAM是一种好发于中老年人的疾病，有发展为黑色素瘤的倾向。青少年的痣可能会引发强烈的淋巴细胞反应，在临床和组织学上可能与其他病变混淆，尤其是主要发生在成年人中的消退期黑色素瘤结节。很少能发现先天性结膜痣，有时在伴有相邻眼睑先天性痣患者中出现。结膜中可发现多种不寻常的痣，包括气球样细胞痣、斯皮茨痣、上皮样细胞痣、发育异常痣、复发性痣、巩膜表层黑色素沉着症以及太田痣、蓝色痣和细胞性蓝色痣、黑色素细胞瘤以及复合痣或混合痣。本文描述了这些以及结膜其他良性色素沉着性疾病的组织发生概念以及临床、光学显微镜和超微结构特征。
