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角膜原位癌又称Bowen病,由美国皮肤科医生Bowen首先报道,故称Bowen病。近年有人认为称上皮内上皮癌较合适。现将我们遇到的2例报告如下: 例1.患者男,72岁,发现右眼角膜缘白色无痛性肿物1年,于1993年10月入院。查:右眼鼻侧角膜缘2点钟呈三角形如胬肉样、表面胶冻样白色隆起约3cm×3cm,裂隙灯下见肿物与周围正常组织界线分明,角膜基质切面清晰,周围组织无浸润,手术中发现肿物质较脆,与角膜易分离。病理诊断为鳞状上皮增生Ⅰ～Ⅱ型(未确诊有癌变)。1995年7月复诊,右眼3点钟角膜缘外又有一白色胶冻样新生物约1.5cm×1.5mm,切除病理诊断同前。1996年3月5日因右眼角膜缘新生物再次复发,再来我院复查:右眼5点钟处角膜缘又有一霜白色胶冻状肿物,约3mm×2mm,裂隙灯见肿物位于角膜上皮下,前端呈锯齿状进行,与周围组织界线分明,立即局麻下手术切除,病理检查示病变仅限于表皮层基底膜完整,鳞状上异型,皮增生细胞大小不一,排列紊乱,核畸形,浓染,核分裂相易见,还可见瘤巨细胞,表皮角化过度与角化不全(见图1),确诊为Bowen病。手术后给予90Sr贴敷。
Corneal carcinoma in situ, also known as Bowen’s disease, was first reported by the American dermatologist Bowen, so it was called Bowen’s disease. In recent years, some people think that the more appropriate intraepithelial epithelial cancer. We now encounter two cases are reported as follows: Example 1. Male patient, aged 72, found the right corneal edge of white painless tumor for 1 year, in October 1993 admitted. Check: The right eye nasal corneal edge at 2 o’clock was a triangle such as flesh-like, the surface of the jelly-like white uplift about 3cm × 3cm, see the tumor under the slit lamp and surrounding normal tissue clear line, corneal clear section of the matrix, surrounding tissue Infiltration, surgery found swollen substance more brittle, and corneal easily separated. Pathological diagnosis of squamous epithelial hyperplasia Ⅰ ~ Ⅱ type (not diagnosed with cancer). July 1995 referral, right eye 3 o’clock corneal margin and a white jelly-like new biological about 1.5cm × 1.5mm, removal of the same pathological diagnosis. March 5, 1996 because of the right corneal limbs again recurrence of new organisms, and then review our hospital: Right eye at 5 o’clock in the corneal margin and a frost white jelly-like mass, about 3mm × 2mm, slit lamp, see the tumor located Corneal epithelium, the front was jagged, with clear boundaries with the surrounding tissue, immediately under local anesthesia surgery, pathological examination revealed lesions limited to the epidermal basement membrane integrity, squamous on the shape of the proliferation of epithelial cells of varying sizes, arranged in disorder, Nuclear deformity, staining, mitotic easy to see, but also visible tumor giant cells, epidermal hyperkeratosis and parakeratosis (see Figure 1), diagnosed as Bowen’s disease. Apply 90Sr after surgery.