A Case of Solitary Nonvascularized Corneal Epithelial Dysplasia.
A Case of Solitary Nonvascularized Corneal Epithelial Dysplasia.
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DOI：
10.1155/2016/5687285
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Saika S
中科院分区：
文献类型：
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作者：
Morii T;Sumioka T;Izutani-Kitano A;Takada Y;Okada Y;Kao WW;Saika S
背景资料。上皮异型增生属于结膜/角膜上皮内瘤变，是一种癌前病变。病变通常发生在角膜缘区域，并向中央角膜生长，伴随着病变内新生血管的形成。在此，我们报告一例孤立性非血管化角膜上皮异常增殖症，周围有正常角膜上皮，免疫组织化学发现眼表组织细胞角蛋白，例如角蛋白13和角蛋白12。一位76岁的男性因左眼局部角膜上皮混浊的视力障碍而向我们咨询。右眼视力为20/20，左眼视力为20/200。裂隙灯检查显示，他的左侧角膜上皮中央有一个白色斑块样病变。未发现病变血管侵犯。手术切除病变并进行组织病理学检查，诊断为上皮异型增生。直接快速猩红4BS(DFS)染色排除淀粉样变性。免疫组织化学结果显示，异型增生上皮细胞表达角蛋白13和波形蛋白，而不表达角蛋白12，提示肿瘤上皮细胞缺乏角膜上皮细胞分化。结论。该病变被诊断为眼表非血管化上皮异型增生。病变的病因尚不清楚。
Background. Epithelial dysplasia is categorized as conjunctival/corneal intraepithelial neoplasia which is a precancerous lesion. The lesion is usually developed at the limbal region and grows towards central cornea in association with neovascularization into the lesion. Here, we report a case of isolated nonvascularized corneal epithelial dysplasia surrounded by normal corneal epithelium with immune histochemical finding of ocular surface tissues cytokeratins, for example, keratin 13 and keratin 12. Case Presentation. A 76-year-old man consulted us for visual disturbance with localized opacification of the corneal epithelium in his left eye. His visual acuity was 20/20 and 20/200 in his right and left eye, respectively. Slit lamp examination showed a whitish plaque-like lesion at the center of his left corneal epithelium. No vascular invasion to the lesion was found. The lesion was surgically removed and subjected to histopathological examination and diagnosed as epithelial dysplasia. Amyloidosis was excluded by direct fast scarlet 4BS (DFS) staining. Immunohistochemistry showed that the dysplastic epithelial cells express keratin 13 and vimentin, but not keratin 12, indicating that the neoplastic epithelial cells lacked corneal-type epithelium differentiation. Conclusions. The lesion was diagnosed as nonvascularized epithelial dysplasia of ocular surface. Etiology of the lesion is not known.