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目的观察脉络膜黑色素瘤的组织病理学特征。方法回顾分析64例病理确诊的脉络膜黑色素瘤病理资料。按照美国眼黑色素瘤多中心研究组的测量方法和WHO的分类标准,测量和观察大体标本中的肿瘤大小和光学显微镜下的肿瘤细胞学类型;以肿瘤前缘累及部位对肿瘤所处位置进行分类;以肿瘤细胞向外浸润程度对肿瘤蔓延程度进行分级。结果64例脉络膜黑色素瘤中,大肿瘤25例,占39.1%;中等大小肿瘤31例,占48.4%;小肿瘤8例,占12.5%。梭形细胞型42例,占65.6%,其中,梭形细胞A型15例,占23.4%,梭形细胞B型27例,占42.3%;上皮样细胞型7例,占10.9%;混合型10例,占15.6%;其它型5例,占7.8%。肿瘤细胞未累及巩膜者25例,占39.1%;累及巩膜但限于巩膜层内者22例,占34.4%;穿透巩膜全层达眼球表面者12例,占18.7%;眶内浸润者5例,占7.8%。结论脉络膜黑色素瘤组织病理学特征变化多样,临床上以梭形细胞型最常见,易伴巩膜浸润。
Objective To observe the histopathological features of choroidal melanoma. Methods Retrospective analysis of 64 cases of pathologically confirmed choroidal melanoma pathology data. The tumor size and the cytological types under light microscopy were measured and observed according to the American Methodology of Melanoma Melanoma Multi-center Study Group and the WHO classification criteria; the location of the tumor was classified based on the location of the leading edge of the tumor The extent of tumor spread was graded by the degree of tumor cells infiltrating outward. Results Of the 64 cases of choroidal melanoma, 25 cases were large tumors (39.1%), 31 cases were medium tumors (48.4%), and 8 (12.5%) were small tumors. Spindle cell type in 42 cases, accounting for 65.6%, of which 15 cases of spindle cell type A, accounting for 23.4%, 27 cases of spindle cell type B, accounting for 42.3%; epithelial cell type in 7 cases, accounting for 10.9% 10 cases, accounting for 15.6%; the other 5 cases, accounting for 7.8%. Tumor cells did not involve the sclera in 25 cases, accounting for 39.1%; involving the sclera but limited to the scleral 22 cases, accounting for 34.4%; penetrating the scleral full layer of the eye surface in 12 cases, accounting for 18.7%; infiltration orbital infiltration in 5 cases , Accounting for 7.8%. Conclusion Choroidal melanoma has many histopathological features. Most of them are spindle-shaped cells in clinical practice, and are easily associated with scleral infiltration.