Wu Dan, Qian Tingting, Nakao Takeshi, Xu Jianjiang, Liu Zuguo, Sun Xinghuai, Chu Yiwei, Hong Jiaxu
Department of Ophthalmology and Visual Science and Eye Research Institute, Eye, and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
Department of Immunology, Shanghai Medical College, Fudan University, Shanghai, China.
Oncotarget. 2017 Jan 10;8(2):2020-2024. doi: 10.18632/oncotarget.13961.
Conjunctival pyogenic granulomas are commonly seen after ocular surgeries or at an ocular wound site. The aim of this study is to describe a novel histological classification for medically uncontrolled conjunctival pyogenic granulomas (MUCPG), and to explore whether the diversity in clinical features correlates to different histological subtypes of MUCPG.
This is an observational cross-section case series. We reviewed 46 consecutive patients with conjunctival pyogenic granulomas who did not respond to topical corticosteroids and underwent surgical excision from January 1, 2006 through December 31, 2015. Clinical features and histological findings were presented and analyzed.
Ocular surgery, accidental injury, and chalazion were the main predisposing causes of MUCPG. The lesions tended to occur unilaterally on the bulbar conjunctiva. Forty patients (87%) presented an enrichment of inflammatory cells and proliferated capillaries in their pathological sections (inflammatory pattern). Six patients (13%) showed relatively few inflammatory cells and capillaries within fibrous stroma (fibrous pattern). Patients with the inflammatory pattern were older (p = 0.025) and tended to be located in bulbar conjunctiva (p = 0.002). The predisposing causes were also different between two histological subtypes (p = 0.007).
We found the correlation between clinical presentation and histological subtypes in patients with MUCPG, indicating this disease may need a new classification scheme.
结膜化脓性肉芽肿常见于眼部手术后或眼部伤口部位。本研究的目的是描述一种针对药物治疗无效的结膜化脓性肉芽肿（MUCPG）的新型组织学分类，并探讨临床特征的多样性是否与MUCPG的不同组织学亚型相关。
这是一项观察性横断面病例系列研究。我们回顾了2006年1月1日至2015年12月31日期间连续46例对局部糖皮质激素治疗无反应并接受手术切除的结膜化脓性肉芽肿患者。呈现并分析了临床特征和组织学发现。
眼部手术、意外伤害和睑板腺囊肿是MUCPG的主要诱发原因。病变倾向于单侧发生在球结膜。40例患者（87%）的病理切片显示炎症细胞和增殖的毛细血管增多（炎症型）。6例患者（13%）在纤维基质内显示相对较少的炎症细胞和毛细血管（纤维型）。炎症型患者年龄较大（p = 0.025），且倾向于位于球结膜（p = 0.002）。两种组织学亚型的诱发原因也不同（p = 0.007）。
我们发现MUCPG患者的临床表现与组织学亚型之间存在相关性，表明这种疾病可能需要一种新的分类方案。
