Treatment and histopathology of a congenital vitreous cyst.
Treatment and histopathology of a congenital vitreous cyst.
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先天性玻璃体囊肿的治疗和组织病理学。
DOI：
10.1016/s0161-6420(98)95020-5
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发表时间：
1998
期刊：
影响因子：
--
通讯作者：
Millecchia,LL
中科院分区：
文献类型：
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作者：
Nork,TM;Millecchia,LL
目的评价先天性玻璃体囊肿的治疗效果，并对囊肿进行组织病理学检查，以确定其细胞组成和可能的来源。研究设计研究设计是一份病例报告，包括临床病理相关性。一位35岁的女性，从小就患有玻璃体囊肿，并因其症状而越来越困扰。囊肿最初采用氩激光光凝治疗。由于缩小后的囊肿仍在视轴附近，随后进行了玻璃体切除术。组织病理学研究包括光镜和电镜；肌动蛋白和胶质原纤维酸性蛋白（GFAP）免疫细胞化学；碳酸酐酶（CA）的酶组织化学。结果囊肿由单层重色素细胞组成，沿细胞内缘有厚的基底膜。在超微结构上，细胞连接紧密，顶端有微绒毛突起，在不同的成熟阶段含有大量的大黑素体，包括前黑素体。免疫化学显示细胞肌动蛋白阳性，GFAP阴性。CA的酶组织化学染色也呈强阳性。结论：该囊肿局限于Cloquet管区，存在Mittendorf点，囊肿存在多年，并且发现色素上皮型细胞具有未成熟的黑素体（出生后正常色素上皮中未见的特征），作者认为该囊肿是原发性透明体系统的先天性残余。由于色素细胞通常不存在于眼睛的这一部分，囊肿是原发透明体系统的脉络膜瘤。
OBJECTIVEThis study aimed to evaluate the treatment efficacy of a congenital vitreous cyst and to examine the cyst histopathologically to determine its cellular makeup and possible origin.STUDY DESIGNThe study design was a case report, including a clinicopathologic correlation.INTERVENTIONA 35-year-old woman with a known vitreous cyst since childhood became increasingly troubled by its symptoms. The cyst was treated initially with argon laser photocoagulation. Vitrectomy subsequently was performed because the deflated cyst remained near the visual axis. Histopathologic studies included light and electron microscopy; immunocytochemistry for actin and glial fibrillary acidic protein (GFAP); and enzyme histochemistry for carbonic anhydrase (CA).RESULTSThe cyst was composed of a single layer of heavily pigmented cells with a thick basement membrane along the internal borders of the cells. Ultrastructurally, the cells were connected with tight junctions, had microvillous processes at their apices, and contained numerous large melanosomes in various stages of maturity, including premelanosomes. Immunochemistry showed the cells were positive for actin but negative for GFAP. Enzyme histochemical staining for CA also was strongly positive.CONCLUSIONSThe confinement of this cyst to the region of Cloquet’s canal, the presence of a Mittendorf’s dot, the cyst’s existence for many years, and the finding of pigment epithelial-type cells having immature melanosomes (a feature not seen after birth in normal pigment epithelium) lead the authors to believe that this cyst was a congenital remnant of the primary hyaloidal system. Because pigmented cells are not normally present in this part of the eye, the cyst was a choristoma of the primary hyaloidal system.