Ueno H, Tamai A, Noda K, Kishi S, Iyota K, Masaoka N, Wada H
Jpn J Ophthalmol. 1983;27(3):459-67.
The authors experienced one case of malignant melanoma of the superior palpebral conjunctiva and the inferior palpebral skin, originating from benign acquired melanosis of the bulbar conjunctiva which developed in a 48-year-old man. Orbital exenteration including superior and inferior palpebrae was performed, and the removed tissue was examined by light and electron microscopy. In the temporal bulbar conjunctiva, melanocytes containing abundant fine melanin granules proliferated over almost the whole area of the epithelial layer. Cellular atypia and karyomitosis were not observed. The basement membrane remained intact with no proliferation of melanocytes in the substantia propria. However, in the perivascular area, in addition to the moderately prominent infiltration by lymphocytes and plasma cells, infiltration by melanophages was observed relatively frequently. Based on these findings, it was confirmed that the primary lesion of the bulbar conjunctiva was an acquired melanosis of Stage IB as classified by Zimmerman. The black nodular tumors of the superior palpebral conjunctiva and inferior palpebral skin consisted of melanoma cells showing markedly prominent cellular and nuclear atypia. The nuclei showed indentations in the membrane with electron-lucent karyoplasm, each having one nucleolus. The cytoplasm contained many round or elongated melanosomes in various developmental stages, with sizes of about 0.7 micron. Scattered among melanoma cells were a number of melanophages which had phagocytized many melanosomes at various stages of maturity.(ABSTRACT TRUNCATED AT 250 WORDS)
作者遇到一例上睑结膜和下睑皮肤恶性黑色素瘤,起源于一名48岁男性球结膜的良性后天性黑素沉着病。进行了包括上下眼睑的眶内容剜除术,并对切除组织进行了光镜和电镜检查。在颞侧球结膜,含有丰富细小黑色素颗粒的黑素细胞在上皮层几乎整个区域增殖。未观察到细胞异型性和核分裂象。基底膜保持完整,固有层无黑素细胞增殖。然而,在血管周围区域,除淋巴细胞和浆细胞中度显著浸润外,相对频繁地观察到噬黑素细胞浸润。基于这些发现,证实球结膜的原发性病变是齐默尔曼分类的IB期后天性黑素沉着病。上睑结膜和下睑皮肤的黑色结节性肿瘤由显示明显细胞和核异型性的黑色素瘤细胞组成。细胞核膜有凹陷,核质电子透亮,各有一个核仁。细胞质含有许多处于不同发育阶段的圆形或细长形黑素体,大小约0.7微米。在黑色素瘤细胞中散在分布着许多噬黑素细胞,它们吞噬了许多处于不同成熟阶段的黑素体。(摘要截短于250字)