Jakobiec F A, Streeten B W, Iwamoto T, Harrison W, Smith B
Ophthalmology. 1981 Dec;88(12):1175-81. doi: 10.1016/s0161-6420(81)34886-6.
Two patients presented with slowly developing papillated or hyperkeratotic lesions of their lid margins that began early in the fourth decade. Upon excision, these tumors were discovered to be examples of syringocystadenoma papilliferum, a lesion not previously well documented in the ophthalmic literature. By light microscopy, each tumor displayed surface poral openings where the epidermis underwent a transition into duct-like epithelium, which ramified as luminal channels throughout the tumor. Papillae projected into many of the duct-like spaces and were lined by columnar to multilaminar nonkeratinizing epithelium. A plasma cell-rich infiltrate was present in the connective tissue cores of the papillae. Electron microscopy performed on one of the lesions revealed that the channels were true ducts, with the innermost cells displaying microvilli, small numbers of tonofilaments, and apical junctional complexes composed of a zonula occludens and zonular adherens. These findings, coupled with the location of the tumors at the lid margin and the presence of dilated apocrine glands of Moll deep to one of the tumors, support an apocrine origin. The clinical differential diagnosis of syringocystadenoma papilliferum with respect to other more common lid tumors is discussed.
两名患者出现睑缘乳头状或角化过度性病变，发展缓慢，始于40岁早期。切除后发现这些肿瘤为乳头状汗腺囊腺瘤，这是一种在眼科文献中此前记录不多的病变。通过光学显微镜观察，每个肿瘤表面可见毛孔开口，此处表皮转变为导管样上皮，在整个肿瘤内分支形成管腔通道。乳头突入许多导管样间隙，内衬柱状至多层非角化上皮。乳头的结缔组织核心有富含浆细胞的浸润。对其中一个病变进行电子显微镜检查发现，这些通道是真正的导管，最内层细胞有微绒毛、少量张力丝以及由紧密连接和黏着小带组成的顶端连接复合体。这些发现，加上肿瘤位于睑缘以及其中一个肿瘤深部存在扩张的Moll大汗腺，支持其大汗腺起源。本文讨论了乳头状汗腺囊腺瘤与其他更常见睑部肿瘤的临床鉴别诊断。
