Pathological typing and clinical features of primary iris stromal cysts

Abstract

Background Primary iris stromal cysts is a rare clinical disease.In recent years, the pathological findings of primary iris stromal cysts are different from previous literature reports.It is very important to understand the pathological characteristics of primary iris stromal cysts for illuminating its pathogenesis and accurate treatment. Objective This study was to analyze the pathological types and clinical manifestations of primary iris stromal cysts. Methods Histopathological sections of 14 patients with primary iris stromal cysts from January 1979 to December 2012 in Tianjin Eye Hospital were retrospectively analyzed.The primary iris stromal cysts were typed based on the hematoxylin-eosin staining, periodic acid-Schiff (PAS) staining and immunochemistry, and the clinical chacteristics upon different types were evaluated. Results In 14 specimens of primary iris stromal cysts, squamous epithelial type was found in 9 specimens, lens epithelial type in 3 specimens and ciliary body epithelial type in 2 specimens.The primary iris stromal cysts of squamous epithelial type were constituted of non-cuticular stratified squamous epithelium cells, and sporadic goblet cells were found in some specimens.The primary iris stromal cysts of lens epithelial type were consisted of lens epithelium cells and lens capsular analogic tissue and the cysts were tightly adherent to the lens.Crystalline lens dysplasia were seen in 2 specimens.The primary iris stromal cysts of ciliary body epithelial type showed single or stratified ciliary body like epithelium cells.Iris-ciliary dysplasia or anterior chamber angle abnormality was displayed in 1 specimen in this type of cysts.Under the slit lamp microscope, superior-temporal clear cysts were often seen in the primary iris stromal cysts of squamous epithelial type, and translucent cysts or diffuse swelling cysts were exhibited in the lens epithelial type and might be accompanied with lens dysplasia and cataract.Diffuse swelling was found in the cysts of ciliary body epithelial type which were often associated with chamber dysplasia and infantile glaucoma. Conclusions Primary iris stromal cysts are pathologically classified into squamous epithelial type, lens epithelial type and ciliary body epithelial type and present with different clinical appearances. Key words: Iris stromal cysts, primary; Pathological classification; Clinical characteristics; Pathogenesis