Depot M J, Jakobiec F A, Dodick J M, Iwamoto T
Ophthalmology. 1984 May;91(5):522-7. doi: 10.1016/s0161-6420(84)34260-9.
A 25-year-old white man had been aware since childhood of yellow discolorations of the medial aspects of his upper lids. The skin changes progressively spread to involve all four eyelids, the inferior skin of the brow, and the lateral and medial canthal skin. The clinical diagnosis was extensive bilateral xanthelasmas . The patient had no manifest abnormality of lipid metabolism, although his father and grandfather had both developed xanthelasmas early in childhood. A snip biopsy of upper lid skin was performed and studied by both light and electron microscopy. The light microscopic appearance confirmed the diagnosis of xanthelasma, in that the upper dermis contained mono- and multinucleated foamy xanthoma cells beset with myriad cytoplasmic vacuoles. Cells displaced outwardly into the interstitium evidenced degradation phenomena within the vacuoles, consisting of lamellar bodies or fingerprint-like inclusions, presumably the result of fusion of lysosomes with the lipidic inclusions. Scattered non- lipidized mononuclear histiocytes with abundant profiles of smooth-surfaced endoplasmic reticulum possibly represented a reserve population of monocytes for conversion into xanthoma cells.
一名25岁的白人男性自幼就注意到其上眼睑内侧发黄。皮肤变化逐渐蔓延至累及所有四个眼睑、眉部下侧皮肤以及内外眦皮肤。临床诊断为广泛性双侧睑黄瘤。尽管患者的父亲和祖父在童年早期都出现了睑黄瘤，但该患者脂质代谢无明显异常。对上眼睑皮肤进行了剪取活检，并通过光学显微镜和电子显微镜进行研究。光学显微镜下的表现证实了睑黄瘤的诊断，因为真皮上层含有单核和多核泡沫状黄色瘤细胞，充满了无数的细胞质空泡。向外移入间质的细胞在空泡内呈现降解现象，由板层小体或指纹样包涵体组成，推测是溶酶体与脂质包涵体融合的结果。散在的非脂质化单核组织细胞，其滑面内质网丰富，可能代表了可转化为黄色瘤细胞的单核细胞储备群体。
