特異な病理組織像を呈した角膜上皮異形成の1例

A case of corneal intraepithelial dysplasia with atypical histopathological findings

要約　目的：特異な病理組織像を呈した角膜上皮異形成の1症例の報告。症例：70歳男性が1か月前からの進行性の右眼異物感と視力低下で受診した。矯正視力は右0.3，左1.2で，右眼の角膜上皮内に限局する白色混濁と隆起があった。病巣を切除し，細胞診でわずかな角膜上皮異型性があった。1か月後に角膜の白色病変が再発し，再切除をした。病理検査で，前回とは異なる上皮異形成があり，非典型的角膜上皮異形成と診断した。マイトマイシンC点眼を行い，以後8か月間，再発はない。結論：特異な病理組織所見を呈する角膜上皮異形成に，病変切除とマイトマイシンC点眼が奏効した。

Abstract.　Purpose：To report a case of corneal intraepithelial dysplasia with atypical histopathological findings. Case：A 70-year-old male presented with blurring and foreign body sensation in the right eye since one month before. Corrected visual acuity was 0.3 right and 1.2 left. The right eye showed an opaque infiltration with irregular surface localized to the corneal epithelium. Histopathology of the excised lesion showed mild intraepithelial dysplasia. The corneal lesion recurred one month later and was excised again. Histopathological studies showed atypical intraepithelial dysplasia with various degrees of cellular polarity. The eye received instillation of mitomycin C. These has been no recurrence for 8 months until present. Conclusion：Excision and instillation of mitomycin C was effective for corneal intraepitherial dysplasia with atypical histopathological findings.