Complex clinical and cytological diagnosis of eye adnexa epithelial tumors

S. Saakyan, M. G. Zhiltsova, Yu. I. Borodin, A. Y. Tsygankov
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Abstract

Purpose. Studying clinical and cytological signs of malignant epithelial genesis tumors of eye adnexa. Material and methods. In 2015–2020, 308 patients aged from 23 to 87 (58.0 ± 6.7) years with suspected malignant neoplasms of eyelid skin and conjunctiva were cytologically examined. The material for cytological examination was obtained by scraping (n = 271; 88 %), imprinting (n = 27; 8.8 %), and fine needle aspiration biopsy (n = 10; 3.2 %) if the neoplasm was more than 10 mm thick. Preparations were processed and fixed according to the standard technique using panchromic Pappenheim staining. Results. The cytological analysis confirmed the clinical diagnosis and the epithelial genesis of the malignant neoplasm in 273 (88.7 %) patients. The benign nature of the tumor was confirmed in 17 patients (5.5 %) and the non-tumor nature of the process was confirmed in 11 patients (3.6 %). In the group of malignant tumors, basal cell cancer prevailed, affecting 240 patients (87.9 % of all malignant tumors). 27 patients (9.9% ) had squamous cell cancer, 4 patients had meibomian gland cancer in 4 patients, and 2 patients had undifferentiated cancer. Benign tumors included papillomas (n = 11), while tumor-like lesions included atheromas (n = 3) and granulation polyps (n = 3). Non-tumor lesions involved productive inflammation of the chalazion type (n = 7), or chronic inflammation of a reactive nature (n = 4). 22 patients had histological examination to check the diagnosis, in all cases the histological outcome coincided with the cytological diagnosis. Conclusion. The comprehensive clinical and cytological study allowed us to specify cytomorphological characteristics of epithelial tumors of the eye adnexa: the basal cell cancer and its varieties according to the clinical forms of the tumor, squamous cell cancer and meibomian gland cancer, and papilloma. The complex clinical and cytological method of diagnostics is easily applicable in out-patient conditions, allowing us to specify the diagnosis during the initial visit, which considerably reduces the time required for full patient’s examination.
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眼部附件上皮肿瘤的复杂临床和细胞学诊断
研究目的研究眼附件恶性上皮性肿瘤的临床和细胞学征象。材料与方法。2015-2020年,对308名年龄在23-87(58.0±6.7)岁的眼睑皮肤和结膜疑似恶性肿瘤患者进行了细胞学检查。用于细胞学检查的材料通过刮取(n = 271;88%)、压片(n = 27;8.8%)和细针穿刺活检(n = 10;3.2%)获得,如果肿瘤厚度超过 10 毫米。按照标准技术使用全色帕本海姆染色法对制备物进行处理和固定。结果细胞学分析证实了 273 例(88.7%)患者的临床诊断和恶性肿瘤的上皮起源。17名患者(5.5%)的肿瘤被证实为良性,11名患者(3.6%)的肿瘤被证实为非肿瘤。在恶性肿瘤中,基底细胞癌占多数,有 240 名患者(占所有恶性肿瘤的 87.9%)。27 名患者(9.9%)患有鳞状细胞癌,4 名患者患有睑板腺癌,2 名患者患有未分化癌。良性肿瘤包括乳头状瘤(11 例),肿瘤样病变包括粥样瘤(3 例)和肉芽肿息肉(3 例)。非肿瘤病变包括霰粒肿类型的生产性炎症(7 例)或反应性慢性炎症(4 例)。22 名患者接受了组织学检查以确诊,所有病例的组织学结果均与细胞学诊断一致。最后得出结论。通过对临床和细胞学的综合研究,我们明确了眼部附件上皮肿瘤的细胞形态学特征:基底细胞癌及其根据肿瘤临床形态划分的种类、鳞状细胞癌和睑板腺癌以及乳头状瘤。这种复杂的临床和细胞学诊断方法易于在门诊条件下使用,使我们能够在初次就诊时明确诊断,从而大大减少了对病人进行全面检查所需的时间。
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