Shields J A, Sanborn G E, Augsburger J J
Ophthalmology. 1983 Jun;90(6):716-20. doi: 10.1016/s0161-6420(83)34500-0.
The records of 200 consecutive patients referred to the Ocular Oncology Service of Wills Eye Hospital because of an iris lesion suspected of being an iris melanoma were reviewed. On clinical evaluation, 24% of the lesions met the criteria for the diagnosis of iris melanoma and 76% were diagnosed as simulating lesions (pseudomelanomas). The most common pseudomelanomas included primary iris cyst (38%), iris nevus (31%), essential iris atrophy (5.7%), iris foreign body (4.5%), peripheral anterior synechia (2.5%), and iris metastasis (2.5%). Less frequently encountered pseudomelanomas included aphakic iris cysts, leiomyoma, melanocytoma, reactive lymphoid hyperplasia, adenoma of iris pigment epithelium, iridoschisis, and other miscellaneous entities. The clinical features that are helpful in differentiating the more common iris pseudomelanomas from true melanomas are discussed. Correct clinical identification of these simulating lesions may prevent unnecessary surgery or other treatment.
对因怀疑虹膜病变为虹膜黑色素瘤而转诊至威尔斯眼科医院眼肿瘤服务中心的200例连续患者的记录进行了回顾。经临床评估，24%的病变符合虹膜黑色素瘤的诊断标准，76%被诊断为模拟病变（假黑色素瘤）。最常见的假黑色素瘤包括原发性虹膜囊肿（38%）、虹膜痣（31%）、原发性虹膜萎缩（5.7%）、虹膜异物（4.5%）、周边前粘连（2.5%）和虹膜转移瘤（2.5%）。较少见的假黑色素瘤包括无晶状体虹膜囊肿、平滑肌瘤、黑素细胞瘤、反应性淋巴样增生、虹膜色素上皮腺瘤、虹膜劈裂症及其他杂类病变。讨论了有助于区分较常见的虹膜假黑色素瘤与真性黑色素瘤的临床特征。对这些模拟病变进行正确的临床识别可避免不必要的手术或其他治疗。
