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目的 :探讨脉络膜血管瘤临床、病理及免疫组织化学改变。方法 :回顾分析 8例病理诊断为脉络膜血管瘤的临床和病理资料 ,并对其中 7例眼球标本行 VEGF、 CD34等免疫组织化学检查。结果 :摘除眼球前 2例误诊为恶性脉络膜黑色素瘤 ,2例拟诊脉络膜血管瘤 ,4例脉络膜肿物性质待查 ,其中 5例合并新生因管性青光眼 ,全部伴渗出性视网膜脱离。病理证实为脉络膜海绵状血管瘤 ,其间被纤维结缔组织分隔 ,5例瘤体表面见视网膜色素上皮细胞脱失及 2例视网膜下见成簇状含有色素的巨噬细胞。免疫组织化学检查 :脉络膜血管瘤内皮细胞 CD34均呈强阳性 ,而 VEGF阴性表达 ,2例见个别细胞呈弱阳性。结论 :病史较长 ,各种检查提示有脉络膜肿物 ,伴视网膜脱离的继发性青光眼患者 ,应高度怀疑脉络膜血管瘤。免疫组织化学显示脉络膜血管瘤是毛细血管内皮细胞源性的良性肿瘤
Objective: To investigate the clinical, pathological and immunohistochemical changes of choroidal hemangiomas. Methods: The clinical and pathological data of 8 cases of choroidal hemangioma were retrospectively analyzed. Seven of them were examined by immunohistochemistry such as VEGF and CD34. RESULTS: Two cases were misdiagnosed as malignant choroidal melanoma before removal of the eyeball, 2 cases were diagnosed choroidal hemangiomas, and 4 cases of choroidal neoplasms were to be investigated. Among them, 5 cases were associated with neovascular glaucoma and all had exudative retinal detachment. Pathologically confirmed as choroidal cavernous hemangioma, separated by fibrous connective tissue, 5 cases of retinal pigment epithelial cells were seen on the surface of tumors, and 2 cases of pigmented macrophages clustered under the retina. Immunohistochemical examination: Choroidal hemangioendothelial cells were strongly positive for CD34 and negative for VEGF expression. Two patients showed weak positive staining in individual cells. Conclusion: The choroidal hemangiomas should be highly suspected in patients with secondary glaucoma with retinal detachment. Immunohistochemistry shows choroidal hemangiomas are benign tumors of capillary endothelial cells