Goto Hiroshi, Yamakawa Naoyuki
Department of Ophthalmology, Tokyo Medical University, Tokyo, Japan.
Ocul Oncol Pathol. 2021 Sep;7(4):267-271. doi: 10.1159/000511550. Epub 2021 May 27.
This report describes the histopathological findings of an iris melanoma that developed in a patient with retinitis pigmentosa (RP). A 66-year-old man was referred to our hospital with a diagnosis of iris tumor. He had a medical history of RP for over 25 years. His best corrected visual acuity at presentation was 20/20 (OD) and 20/200 (OS). Slit lamp examination revealed an iris melanocytoma in his right eye and a brown iris mass involving the pupil in his left eye. Ocular fundus examination of his right eye showed diffuse chorioretinal atrophy with attenuated retinal vessels and scattered pigment. A diagnosis of iris melanoma was made and enucleation of his left eyeball was performed. Histopathological examination of the eyeball showed an iris tumor with proliferation of spindle cells positive for Melan-A, HMB-45, and S-100 protein by immunohistochemistry. Diffuse destruction of retinal architecture was observed, with loss of outer segment and replacement by glial cells. Accumulation of melanin pigment around retinal vessels was found in peripheral retina. These histopathological findings were compatible with advanced stage of RP. This case demonstrates that iris melanoma can occur in eye with RP.
本报告描述了一名患有色素性视网膜炎(RP)的患者发生的虹膜黑色素瘤的组织病理学发现。一名66岁男性因虹膜肿瘤诊断被转诊至我院。他有超过25年的RP病史。就诊时其最佳矫正视力为右眼20/20,左眼20/200。裂隙灯检查发现其右眼有虹膜黑素细胞瘤,左眼有累及瞳孔的褐色虹膜肿物。右眼眼底检查显示弥漫性脉络膜视网膜萎缩,视网膜血管变细,色素散在分布。诊断为虹膜黑色素瘤并对其左眼进行了眼球摘除术。眼球组织病理学检查显示虹膜肿瘤,免疫组化显示梭形细胞增殖,Melan-A、HMB-45和S-100蛋白呈阳性。观察到视网膜结构弥漫性破坏,外节缺失并被神经胶质细胞取代。在外周视网膜发现视网膜血管周围有黑色素沉着。这些组织病理学发现与RP晚期相符。该病例表明虹膜黑色素瘤可发生于患有RP的眼睛。