Jakobiec F A, Sacks E, Lisman R L, Krebs W
Department of Ophthalmology, Manhattan Eye, Ear & Throat Hospital, New York, NY 10021.
Arch Ophthalmol. 1988 May;106(5):661-4. doi: 10.1001/archopht.1988.01060130715031.
A 39-year-old black woman had a 12-year history of slowly progressive left temporal juxtalimbal conjunctival swelling. The lesion was freely movable over the surface of the globe and was believed to be situated within the substantia propria. Histopathologic evaluation of the excised tissue disclosed that it was a collagenous mass of lamellar architecture, with a hypocellular dispersion of mesenchymal cells and a scattering of capillaries in the absence of inflammation. Electron microscopic examination revealed that the lamellar arrangement had regular lobular subdivisions composed of collagen fibers approximately 50 nm in diameter. Compressed fibroblasts occupied the peripheries of the lobules; the former exhibited abundant rough-surfaced endoplasmic reticulum and failed to elaborate basement membrane material. Delicate processes of the fibroblasts extended into the centers of the collagenous aggregates. To our knowledge, this is the first convincingly documented case of an acquired fibroma of the substantia propria of the epibulbar conjunctiva. The differential diagnosis in this case included related fibroblastic and simulating nonfibroblastic lesions.
一名39岁的黑人女性有12年缓慢进展的左颞侧近角膜缘结膜肿胀病史。该病变在眼球表面可自由移动，据信位于固有层内。对切除组织的组织病理学评估显示，它是一个具有层状结构的胶原性肿块，间充质细胞呈低细胞性分散，且有散在的毛细血管，无炎症。电子显微镜检查显示，层状排列有规则的小叶细分，由直径约50纳米的胶原纤维组成。压缩的成纤维细胞占据小叶周边；前者内质网表面粗糙丰富，未形成基底膜物质。成纤维细胞的纤细突起延伸至胶原聚集体中心。据我们所知，这是第一例有令人信服记录的眼球结膜固有层获得性纤维瘤病例。该病例的鉴别诊断包括相关的成纤维细胞性病变和类似的非成纤维细胞性病变。
