Ultrasonographic features of adenoma of the nonpigmented ciliary epithelium_Chinese Journal of Ocular Fundus Diseases

Authors：

Li Dongjun , Yang Wenli ,  Wei Wenbin , Xu Xiaolin , Wang Ziyang , Chen Wei , Zhao Qi , Li Yifeng , Cui Rui , Shen Lin , Liu Qian , Wei Chuanchuan

Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophtahlmology & Visual Sciences Key Laboratory, Medical Artificial Intelligence Research and Verification Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China;

Corresponding?author：

Wei Wenbin, Email: weiwenbintr@163.com

Keywords：

Adenoma; Ciliary body; Pigment epithelium of eye; Melanoma; Ultrasound biomicroscopy

DOI：

10.3760/cma.j.cn511434-20220209-00073

Video：

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Objective To analyze the ultrasonographic features of adenoma of the nonpigmented ciliary epithelium (ANPCE). Methods A retrospective series of case studies. From January 2014 to October 2021, 31 patients (31 eyes) with ANPCE (ANPCE group) were diagnosed in the eye center of Beijing Tongren Eye Center of Beijing Tongren Hospital, Capital Medical University, and 17 patients (17 eyes) with ciliary body melanoma (control group) diagnosed at the same time were selected as the control group. There was no significant difference in age (t=－0.564) and sex composition ratio (χ²=0.182) between the two groups (P=0.576, 0.670). All patients underwent ultrasound biomicroscopy to obtain the measurement parameters: tumor height, maximum basal diameter, maximum diameter, ratio of maximum diameter to basal diameter and ratio of maximum diameter to height; tumor location, shape, internal echogenicity intensity, echogenicity uniformity, degree of sound attenuation, invasion of iris, anterior displacement of the iris, lens subluxation were observed. The measurement parameters and observation indexes of the two groups were compared by independent sample t-test and χ² test. Receiver operating characteristic (ROC) curve was drawn, area under the ROC curve (AUC) was determined, and parameter indicators with differential diagnosis value were screened. Results The maximum diameter, height, maximum basal diameter, ratio of the maximum diameter to the maximum basal diameter, and the ratio of the maximum diameter to the height of the tumors in the ANPCE group and the control group were 5.64±0.98 mm, 4.24±0.59 mm, 3.66±0.71 mm, 1.58±0.34, 1.34±0.19 and 7.82±2.03 mm, 4.47±2.44 mm, 7.02±1.96 mm, 1.13±0.16, 2.09±1.06. The maximum diameter, the maximum basal diameter, and the ratio of the maximum diameter to the height of the tumor in the ANPCE group were all smaller than those of the control group, and the ratio of the maximum diameter to the maximum basal diameter was greater than that of the control group, and the differences were statistically significant (t=－4.159, －6.808,－2.924, 6.257; P<0.05). The tumors in the ANPCE group were mainly spherical (87.1%, 27/31), with no significant acoustic attenuation (77.4%, 24/31), less invading the root iris (77.4%, 24/31), and the tumors were mostly located in the ciliary body coronal (74.2%, 23/31); tumors in the control group were mainly hemispherical (47.1%, 8/17) or spherical (47.1%, 8/17), with significant sound attenuation (76.5%, 13/17), most of the tumors invaded the iris (70.6%, 12/17), and the tumors were mostly located from the pars plana to the coronal (76.5%, 13/17). There were statistically significant differences in the position, shape, sound attenuation degree, and whether it invaded the iris between the two groups of eyes (χ²=15.132, 19.767, 13.118, 10.581; P<0.05). The results of ROC curve analysis showed that the ratio of the largest diameter to the largest base diameter, the degree of sound attenuation and the AUC of whether the iris was violated were higher, which were 0.881, 0.769, and 0.740, respectively. Conclusions Ultrasound biomicroscopy is helpful in the diagnosis and differential diagnosis of ANPCE and ciliary body melanoma. The ratio of maximum diameter to maximum basal diameter, the degree of sound attenuation and whether it invades the root iris are important parameters to distinguish the two tumors.

Citation： Li Dongjun, Yang Wenli, Wei Wenbin, Xu Xiaolin, Wang Ziyang, Chen Wei, Zhao Qi, Li Yifeng, Cui Rui, Shen Lin, Liu Qian, Wei Chuanchuan. Ultrasonographic features of adenoma of the nonpigmented ciliary epithelium. Chinese Journal of Ocular Fundus Diseases, 2022, 38(3): 191-196. doi: 10.3760/cma.j.cn511434-20220209-00073 Copy

1.	Shields JA, Augsburger JJ, Wallar PH, et al. Adenoma of the nonpigmented epithelium of the ciliary body[J]. Ophthalmology, 1983, 90(12): 1528-1530. DOI: 10.1016/s0161-6420(83)34353-0.
2.	胡蓉, 張科, 朱小華, 等. 睫狀體無色素上皮腺瘤1例[J]. 臨床與病理雜志, 2021, 41(5): 1213-1219. DOI: 10.3978/j.issn.2095-6959.2021.05.037.Hu R, Zhang K, Zhu XH, et al. A case of adenoma of nonpigmented ciliary epithelium[J]. J Clin Pathol Res, 2021, 41(5): 1213-1219. DOI: 10.3978/j.issn.2095-6959.2021.05.037.
3.	李靜, 葛心, 馬建民. 睫狀體無色素上皮腺瘤誤診黑色素瘤一例[J]. 中國醫師雜志, 2015, 17(5): 781-782. DOI: 10.3760/cma.j.issn.1008-1372.2015.05.048.Li J, Ge X, Ma JM, et al. A case of misdiagnosed melanoma in adenoma of nonpigmented ciliary epithelium[J]. Journal of Chinese Physician, 2015, 17(5): 781-782. DOI: 10.3760/cma.j.issn.1008-1372.2015.05.048.
4.	Cursiefen C, Schl?tzer-Schrehardt U, Holbach LM, et al. Adenoma of the nonpigmented ciliary epithelium mimicking a malignant melanoma of the iris[J]. Arch Ophthalmol, 1999, 117(1): 113-116. DOI: 10.1001/archopht.117.1.113.
5.	李彬, 孫憲麗. 52例睫狀體占位病變的組織來源, 臨床特征及組織病理學分析[J]. 中華眼科雜志, 2000, 36(4): 250-254. DOI: 10.3760/j:issn:0412-4081.2000.04.003.Li B, Sun XL. The histogenesis, clinical features and histopathological analysis on 52 cases of ciliary body neoplasms[J]. Chin J Ophthalmol, 2000, 36(4): 250-254. DOI: 10.3760/j:issn:0412-4081.2000.04.003.
6.	Goto H, Yamakawa N, Tsubota K, et al. Clinicopathologic analysis of 32 ciliary body tumors[J]. Jpn J Ophthalmol, 2021, 65(2): 237-249. DOI: 10.1007/s10384-021-00814-y.
7.	Shields JA, Eagle RC Jr, Ferguson K, et al. Tumors of the nonpigmented epithelium of the ciliary body: The Lorenz E. Zimmerman Tribute Lecture[J]. Retina, 2015, 35(5): 957-965. DOI: 10.1097/IAE.0000000000000445.
8.	楊亞麗, 周虹, 趙霓姍, 等. 睫狀體腫瘤18例臨床病理分析[J]. 臨床與實驗病理學雜志, 2021, 37(2): 172-176. DOI: 10.13315/j.cnki.cjcep.2021.02.009.Yang YL, Zhou H, Zhao NS, et al. Clinical and pathological analysis of 18 cases of primary ciliary body occupation[J]. J Clin Exp Pathol, 2021, 37(2): 172-176. DOI: 10.13315/j.cnki.cjcep.2021.02.009.
9.	劉洋. 超聲生物顯微鏡在眼科中的應用進展[J]. 世界最新醫學信息文摘, 2019, 19(93): 60-61. DOI: 10.19613/j.cnki.1671-3141.2019.93.029.Liu Y. The applications and progression of ultrasound biomicroscopy in ophthalmology[J]. World Latest Medicine Information, 2019, 19(93): 60-61. DOI: 10.19613/j.cnki.1671-3141.2019.93.029.
10.	劉顯勇, 張平, 李永平, 等. 睫狀體無色素上皮腺瘤診治分析[J]. 中國實用眼科雜志, 2015, 33(5): 547-551. DOI: 10.3760/cma.j.issn.1006-4443.2015.05.028.Liu XY, Zhang P, Li YP, et al. Adenoma of the nonpigmented ciliary epithelium: an analysis of 5 cases[J]. Chin J Pract Ophthalmol, 2015, 33(5): 547-551. DOI: 10.3760/cma.j.issn.1006-4443.2015.05.028.
11.	Bianciotto C, Shields CL, Guzman JM, et al. Assessment of anterior segment tumors with ultrasound biomicroscopy versus anterior segment optical coherence tomography in 200 cases[J]. Ophthalmology, 2011, 118(7): 1297-1302. DOI: 10.1016/j.ophtha.2010.11.011.
12.	Shields JA, Eagle RC Jr, Shields CL, et al. Acquired neoplasms of the nonpigmented ciliary epithelium (adenoma and adenocarcinoma)[J]. Ophthalmology, 1996, 103(12): 2007-2016. DOI: 10.1016/s0161-6420(96)30393-x.
13.	Yan J, Liu X, Zhang P, et al. Acquired adenoma of the nonpigmented ciliary epithelium: analysis of five cases[J]. Graefe's Arch Clin Exp Ophthalmol, 2015, 253(4): 637-644. DOI: 10.1007/s00417-014-2928-4.
14.	王子楊, 楊文利, 李棟軍, 等. 中小脈絡膜黑色素瘤的超聲診斷及鑒別診斷分析[J]. 中華眼科雜志, 2018, 54(11): 843-848. DOI: 10.3760/cma.j.issn.0412-4081.2018.11.009.Wang ZY, Yang WL, Li DJ, et al. Ultrasound diagnosis and differential diagnosis of medium and small choroidal melanomas[J]. Chin J Ophthalmol, 2018, 54(11): 843-848. DOI: 10.3760/cma.j.issn.0412-4081.2018.11.009.
15.	高飛, 頊曉琳, 張旭, 等. 2010-2019年167例經局部切除術治療的睫狀體腫物的臨床組織病理構成分析[J]. 眼科, 2020, 29(5): 391-395. DOI: 10.13281/j.cnki.issn.1004-4469.2020.05.014.Gao F, Xu XL, Zhang X, et al. Clinical histopathologic constituent analysis of 167 cases of ciliary body mass treated by local resection from 2010 to 2019[J]. Ophthalmology in China, 2020, 29(5): 391-395. DOI: 10.13281/j.cnki.issn.1004-4469.2020.05.014.
16.	方海珍. 標準化A超聯合B超診斷脈絡膜血管瘤和脈絡膜黑色素瘤[J]. 眼視光學雜志, 2003, 5(3): 181-183.Fang HZ. Combination standardized A-scan and high resolution B-scan in the diagnosis of choroidal hemangioma and choroidal malignant melanoma[J]. Chinese Journal of Optometry & Ophthalmology, 2003, 5(3): 181-183.
17.	楊文利, 胡士敏, 朱曉青, 等. 超聲生物顯微鏡診斷眼前節腫瘤[J]. 中華超聲影像學雜志, 2000, 9(1): 39-41. DOI: 10.3760/j.issn:1004-4477.2000.01.018.Yang WL, Hu SM, Zhu XQ, et al. Ultrasound biomicroscopy diagnosis of anterior segment tumors[J]. Chinese Journal of Ultrasonography, 2000, 9(1): 39-41. DOI: 10.3760/j.issn:1004-4477.2000.01.018.
18.	李棟軍, 頊曉琳, 楊文利, 等. 睫狀體黑色素細胞瘤的超聲診斷特征分析[J]. 腫瘤影像學, 2016, 25(4): 297-302. DOI: 10.3969/j.issn.1008-617X.2016.04.002.Li DJ, Xu XL, Yang WL, et al. Analysis of ultrasonographic characteristics of ciliary body melanocytoma[J]. Oncoradiology, 2016, 25(4): 297-302. DOI: 10.3969/j.issn.1008-617X.2016.04.002.
19.	Méndez-Martínez S, Santiago Varela M, Blanco-Teijeiro MJ, et al. Diagnosis and long-term monitoring of adenomas of the ciliary body epithelium by ultrasound biomicroscopy[J]. Eur J Ophthalmol, 2021, 31(4): 2032-2041. DOI: 10.1177/1120672120952645.

1. Shields JA, Augsburger JJ, Wallar PH, et al. Adenoma of the nonpigmented epithelium of the ciliary body[J]. Ophthalmology, 1983, 90(12): 1528-1530. DOI: 10.1016/s0161-6420(83)34353-0.
2. 胡蓉, 張科, 朱小華, 等. 睫狀體無色素上皮腺瘤1例[J]. 臨床與病理雜志, 2021, 41(5): 1213-1219. DOI: 10.3978/j.issn.2095-6959.2021.05.037.Hu R, Zhang K, Zhu XH, et al. A case of adenoma of nonpigmented ciliary epithelium[J]. J Clin Pathol Res, 2021, 41(5): 1213-1219. DOI: 10.3978/j.issn.2095-6959.2021.05.037.
3. 李靜, 葛心, 馬建民. 睫狀體無色素上皮腺瘤誤診黑色素瘤一例[J]. 中國醫師雜志, 2015, 17(5): 781-782. DOI: 10.3760/cma.j.issn.1008-1372.2015.05.048.Li J, Ge X, Ma JM, et al. A case of misdiagnosed melanoma in adenoma of nonpigmented ciliary epithelium[J]. Journal of Chinese Physician, 2015, 17(5): 781-782. DOI: 10.3760/cma.j.issn.1008-1372.2015.05.048.
4. Cursiefen C, Schl?tzer-Schrehardt U, Holbach LM, et al. Adenoma of the nonpigmented ciliary epithelium mimicking a malignant melanoma of the iris[J]. Arch Ophthalmol, 1999, 117(1): 113-116. DOI: 10.1001/archopht.117.1.113.
5. 李彬, 孫憲麗. 52例睫狀體占位病變的組織來源, 臨床特征及組織病理學分析[J]. 中華眼科雜志, 2000, 36(4): 250-254. DOI: 10.3760/j:issn:0412-4081.2000.04.003.Li B, Sun XL. The histogenesis, clinical features and histopathological analysis on 52 cases of ciliary body neoplasms[J]. Chin J Ophthalmol, 2000, 36(4): 250-254. DOI: 10.3760/j:issn:0412-4081.2000.04.003.
6. Goto H, Yamakawa N, Tsubota K, et al. Clinicopathologic analysis of 32 ciliary body tumors[J]. Jpn J Ophthalmol, 2021, 65(2): 237-249. DOI: 10.1007/s10384-021-00814-y.
7. Shields JA, Eagle RC Jr, Ferguson K, et al. Tumors of the nonpigmented epithelium of the ciliary body: The Lorenz E. Zimmerman Tribute Lecture[J]. Retina, 2015, 35(5): 957-965. DOI: 10.1097/IAE.0000000000000445.
8. 楊亞麗, 周虹, 趙霓姍, 等. 睫狀體腫瘤18例臨床病理分析[J]. 臨床與實驗病理學雜志, 2021, 37(2): 172-176. DOI: 10.13315/j.cnki.cjcep.2021.02.009.Yang YL, Zhou H, Zhao NS, et al. Clinical and pathological analysis of 18 cases of primary ciliary body occupation[J]. J Clin Exp Pathol, 2021, 37(2): 172-176. DOI: 10.13315/j.cnki.cjcep.2021.02.009.
9. 劉洋. 超聲生物顯微鏡在眼科中的應用進展[J]. 世界最新醫學信息文摘, 2019, 19(93): 60-61. DOI: 10.19613/j.cnki.1671-3141.2019.93.029.Liu Y. The applications and progression of ultrasound biomicroscopy in ophthalmology[J]. World Latest Medicine Information, 2019, 19(93): 60-61. DOI: 10.19613/j.cnki.1671-3141.2019.93.029.
10. 劉顯勇, 張平, 李永平, 等. 睫狀體無色素上皮腺瘤診治分析[J]. 中國實用眼科雜志, 2015, 33(5): 547-551. DOI: 10.3760/cma.j.issn.1006-4443.2015.05.028.Liu XY, Zhang P, Li YP, et al. Adenoma of the nonpigmented ciliary epithelium: an analysis of 5 cases[J]. Chin J Pract Ophthalmol, 2015, 33(5): 547-551. DOI: 10.3760/cma.j.issn.1006-4443.2015.05.028.
11. Bianciotto C, Shields CL, Guzman JM, et al. Assessment of anterior segment tumors with ultrasound biomicroscopy versus anterior segment optical coherence tomography in 200 cases[J]. Ophthalmology, 2011, 118(7): 1297-1302. DOI: 10.1016/j.ophtha.2010.11.011.
12. Shields JA, Eagle RC Jr, Shields CL, et al. Acquired neoplasms of the nonpigmented ciliary epithelium (adenoma and adenocarcinoma)[J]. Ophthalmology, 1996, 103(12): 2007-2016. DOI: 10.1016/s0161-6420(96)30393-x.
13. Yan J, Liu X, Zhang P, et al. Acquired adenoma of the nonpigmented ciliary epithelium: analysis of five cases[J]. Graefe's Arch Clin Exp Ophthalmol, 2015, 253(4): 637-644. DOI: 10.1007/s00417-014-2928-4.
14. 王子楊, 楊文利, 李棟軍, 等. 中小脈絡膜黑色素瘤的超聲診斷及鑒別診斷分析[J]. 中華眼科雜志, 2018, 54(11): 843-848. DOI: 10.3760/cma.j.issn.0412-4081.2018.11.009.Wang ZY, Yang WL, Li DJ, et al. Ultrasound diagnosis and differential diagnosis of medium and small choroidal melanomas[J]. Chin J Ophthalmol, 2018, 54(11): 843-848. DOI: 10.3760/cma.j.issn.0412-4081.2018.11.009.
15. 高飛, 頊曉琳, 張旭, 等. 2010-2019年167例經局部切除術治療的睫狀體腫物的臨床組織病理構成分析[J]. 眼科, 2020, 29(5): 391-395. DOI: 10.13281/j.cnki.issn.1004-4469.2020.05.014.Gao F, Xu XL, Zhang X, et al. Clinical histopathologic constituent analysis of 167 cases of ciliary body mass treated by local resection from 2010 to 2019[J]. Ophthalmology in China, 2020, 29(5): 391-395. DOI: 10.13281/j.cnki.issn.1004-4469.2020.05.014.
16. 方海珍. 標準化A超聯合B超診斷脈絡膜血管瘤和脈絡膜黑色素瘤[J]. 眼視光學雜志, 2003, 5(3): 181-183.Fang HZ. Combination standardized A-scan and high resolution B-scan in the diagnosis of choroidal hemangioma and choroidal malignant melanoma[J]. Chinese Journal of Optometry & Ophthalmology, 2003, 5(3): 181-183.
17. 楊文利, 胡士敏, 朱曉青, 等. 超聲生物顯微鏡診斷眼前節腫瘤[J]. 中華超聲影像學雜志, 2000, 9(1): 39-41. DOI: 10.3760/j.issn:1004-4477.2000.01.018.Yang WL, Hu SM, Zhu XQ, et al. Ultrasound biomicroscopy diagnosis of anterior segment tumors[J]. Chinese Journal of Ultrasonography, 2000, 9(1): 39-41. DOI: 10.3760/j.issn:1004-4477.2000.01.018.
18. 李棟軍, 頊曉琳, 楊文利, 等. 睫狀體黑色素細胞瘤的超聲診斷特征分析[J]. 腫瘤影像學, 2016, 25(4): 297-302. DOI: 10.3969/j.issn.1008-617X.2016.04.002.Li DJ, Xu XL, Yang WL, et al. Analysis of ultrasonographic characteristics of ciliary body melanocytoma[J]. Oncoradiology, 2016, 25(4): 297-302. DOI: 10.3969/j.issn.1008-617X.2016.04.002.
19. Méndez-Martínez S, Santiago Varela M, Blanco-Teijeiro MJ, et al. Diagnosis and long-term monitoring of adenomas of the ciliary body epithelium by ultrasound biomicroscopy[J]. Eur J Ophthalmol, 2021, 31(4): 2032-2041. DOI: 10.1177/1120672120952645.

Chinese Journal of Ocular Fundus Diseases

Ultrasonographic features of adenoma of the nonpigmented ciliary epithelium

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