Mudhar Hardeep Singh, McGrath Lindsay A, Chung Andy K K, Bowyer Jeremy, Rennie Ian
Department of Histopathology, Royal Hallamshire Hospital, National Specialist Ophthalmic Pathology Service (NSOPS), Sheffield, United Kingdom.
Sheffield Ocular Oncology Service, Royal Hallamshire Hospital, Sheffield, United Kingdom.
Ocul Oncol Pathol. 2020 May;6(3):196-202. doi: 10.1159/000503360. Epub 2019 Oct 29.
To describe the clinical, histological, and immunohistochemical (IHC) features of a series of 10 cases of ocular surface fibroma (OSF) and correlate the findings with other similar histological entities.
The patient demographics and features of the lesions were analysed from the clinical notes. All cases in the series had routine diagnostic excisional biopsies with standard histopathological and IHC evaluation. Each case was analysed by histology and immunohistochemistry with antibodies to: CD34, Factor XIIIa, desmin, smooth muscle actin, S100, Melan-A, β-catenin, neurofilament, and Ki67.
OSF occurred on the bulbar, tarsal, or forniceal conjunctiva, and typically presented as a white, pink, or yellow sheet-like or nodular lesion. The most common symptom was irritation or a foreign-body sensation. Lesions ranged in size from 4 to 13 mm. Only 1/10 cases showed a recurrence after an incomplete excision. Histologically, OSF comprised bland spindle cells in a collagen stroma. The spindle cells were CD34-positive (in 10/10 cases) and a smaller subset was positive for Factor XIIIa (6/10 cases). Normal resident spindle cells in the conjunctival stroma, Tenon's capsule, and tarsal plate were positive for CD34 and Factor XIIIa, implicating these cells in the origin of OSF.
OSF is a benign lesion of resident CD34- and Factor XIIIa-positive spindle cells in the conjunctiva and Tenon's capsule. We have called to attention another lesion to be included by clinicians in the differential diagnosis of benign ocular surface lesions composed of CD34- and Factor XIIIa-positive spindle cells.
描述10例眼表纤维瘤（OSF）的临床、组织学及免疫组化（IHC）特征，并将这些发现与其他相似的组织学实体进行关联。
从临床记录中分析患者的人口统计学资料及病变特征。该系列所有病例均进行了常规诊断性切除活检，并进行标准的组织病理学和免疫组化评估。每例病例均通过组织学和免疫组化分析，使用针对以下指标的抗体：CD34、凝血因子XIIIa、结蛋白、平滑肌肌动蛋白、S100、黑素A、β-连环蛋白、神经丝和Ki67。
OSF发生于球结膜、睑结膜或穹窿结膜，通常表现为白色、粉红色或黄色的片状或结节状病变。最常见的症状是刺激感或异物感。病变大小范围为4至13毫米。仅1/10的病例在不完全切除后出现复发。组织学上，OSF由胶原基质中的温和梭形细胞组成。梭形细胞CD34阳性（10/10例），一小部分凝血因子XIIIa阳性（6/10例）。结膜基质、眼球筋膜囊和睑板中的正常常驻梭形细胞CD34和凝血因子XIIIa阳性，提示这些细胞与OSF的起源有关。
OSF是结膜和眼球筋膜囊中常驻的CD34和凝血因子XIIIa阳性梭形细胞的良性病变。我们提醒临床医生注意，在由CD34和凝血因子XIIIa阳性梭形细胞组成的良性眼表病变的鉴别诊断中应纳入另一种病变。
