眼部肿瘤学课件

肿瘤 是机体在各种致瘤 因素下，局部组织异常 增生而形成的新生物 。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 恶性肿瘤代谢生长能力特 别旺盛，并失去发育成熟 的能力，遗传密码发生了 改变，使细胞调空基因突 变或过量，严重危及生命 。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 肿瘤生长方式 1、膨胀性: 均衡扩展，有包膜 2、浸润性: 无包膜，不均衡 3、外生性: 如乳头状、息肉状 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 眼部肿瘤分类 1、按解剖:睑、结膜 2、按性质:良、恶 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 睑、结、角膜肿瘤 特点: 位置表浅、易诊断 治疗原则: 手术彻底、保护功 能、美容 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 眼睑良性肿瘤 乳头状瘤、色素 痣、皮样 囊肿、血管瘤、黄色瘤。 眼睑恶性肿瘤 基底细胞癌、睑板腺癌、鳞 状细胞癌。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 眼睑血管瘤 为先天发育异常，多数出生即有。少 数幼年或成年出现。病理上分为毛细 血管型和海绵窦型二种。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 毛细血管瘤 较常见，占眼睑血管瘤6070%。 形态多样，位于皮内的有毛细血管 扩张、片状不隆起火焰痣。乳头 状突起草莓痣.位于皮下的，上睑 肥厚肿大婴儿型血管瘤，可累及眼 眶。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. Sturge-weber综合征 为血管瘤 合并其他先天发育异常。 表现为面部火痣，脉络膜血管瘤、同侧 青光眼，大脑多发血管瘤等。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 海绵状血管瘤 占30%，病变位于真皮深层或皮下，结 节状或蚯蚓状，常伴结膜与眼眶血管瘤。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 组织学 大小血管腔、内称内皮细胞。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 治疗 毛细血管瘤型有自愈倾向，先观察再 治疗，有上睑下垂遮盖瞳孔应早手术， 避免弱视。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 方法 瘤体内注射皮质激素、冷冻、激光、手术 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 色素痣 一般出生即有，少数青春期出现 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 组织学 1.皮内痣 痣细胞位于真皮内，扁平微 隆、色淡，有毛或无毛，（有毛必为 皮内痣）一般不恶变。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 2.交界痣 痣细胞位于表皮与真皮之 间无毛，易恶变。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 3.复合痣 含皮内痣与交界痣二种成 份，易恶变。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 4.蓝痣 石板灰色或蓝色，无恶变。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 5.太田痣 为蓝痣的一种，绕眼睑， 眼眶周围。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 眼睑色素痣 外侧睑缘多见 分裂痣 : 上、下睑各 一半 恶变倾向: 痣增大， 色素加 深，边缘有卫星灶、 充血、毛脱落、溃 破 治疗：可不处理,为美容可手术。 恶变须手术加病理。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 黄色瘤 为类脂物质在皮肤中沉积，见于 中老年高血脂、糖尿病患者. 临床表现：多位于上睑内侧近内 眦角皮肤表面，黄白色扁平隆起斑块。 治疗：可不处理 为美容可手术 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 基底细胞癌 发病率首位，老年男性，局限生长， 很少转移，严重亦可引起转移死亡。 好发部位: 下睑、内眦、外眦 形 状 先半透明小结，伴色素,渐发 展为中央溃疡，卷边，鼠咬状， 基底硬，出血渗出，痂皮。 治 疗: 放疗敏感，手术、激光 预后好。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 鳞状细胞癌 起源于皮肤粘膜上皮层恶肿，睑缘为好 发部位，恶性程度高于基底细胞癌，破 坏力大，易转移。bb Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 临床表现 多见于老年男性，下睑 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 1.乳头状或菜花状，脆，可溃破出血。 2.溃疡型 基底高低不平，中央火山喷 火外观，边缘饱满。 晚期 广泛破坏，淋巴转移 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 治疗 手术（局切、眶内容） 放疗（未分化梭形细胞 鳞癌敏感） Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 皮脂腺癌 主要起源于上下睑板腺，称睑板腺癌. 亦可起源于睫毛毛囊的Zeis腺。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 睑板腺癌 临床表现 多见于老年女性，上睑 早期似霰粒肿，易误诊，以后沿 导管向下发展，成为分叶状黄白 色肿块。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 治疗 以手术为主，放疗不敏感 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 结膜肿瘤 良性：色素痣、血管瘤、乳头状瘤、 皮样脂肪瘤。 恶性：鳞状细胞癌，恶性黑色素瘤。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 结膜色素痣 好发于睑裂部、角巩缘、半月 皱襞处，境界清，稍隆起 恶变征象:突然增大，色加深 ， 痣体增生，粗糙， 血管长入 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 鉴别 后天性结膜黑变病，常为单测， 不规则、弥散性色素沉着。一般 30岁后发生，可恶变。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 治疗：病灶小一般不处理，为美容 可手术。有恶变，手术应彻 底。 并作病理检查。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 结膜皮样脂肪瘤 先天性，见于儿童，多为双侧颞上象 限或外眦部球结膜下，黄白色肿块， 质软，病理上主要由脂肪组织构成， 无包膜。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 治疗： 一般不处理，显露多，影响美容 可手术，勿损伤外直肌。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 结膜乳头状瘤 见于任何年龄，常起因于结膜感染。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 临床表现 可发生在穹隆部、泪阜、睑结膜、 或角巩缘，粉红色，花芯样，可 带蒂。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 治疗： 冷冻、手术切除，易复发。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 结膜血管瘤 先天性 1.毛细血管瘤：好发内眦、半月皱壁处， 深红色团状隆起，睑结膜处可带蒂。 2.海绵状血管瘤：紫红色隆起，多叶状， 伴发眶血管瘤。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 鉴别诊断： 结膜血管扩张 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 1.Rendu-Osler-Weber（朗-奥-韦综合征） 又称遗传性多发性毛细血管扩张症。 表现为睑结膜星状、瓣状红色血管瘤伴 出血。全身皮肤、粘膜、内脏多发性毛 细血管扩张。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 2.Louis-Bar（路巴综合征）又称毛细 血管扩张运动失调综合征，为常染色 体 隐性遗传。表现为球结膜鼻侧、 颞侧 对称红色条纹，扇形分布，伴 进行性共济失调。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 结膜鳞状细胞癌 临床表现： 部位：睑裂区角巩缘、睑缘、内眦、 泪阜处。 形态：乳头状、胶状、扁平隆起，可 向深层转移或血管、淋巴转移。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 治疗： 早期，手术切除+整复 晚期，眶内容剜出+放疗 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 角膜皮样瘤 属迷芽瘤（由发病部位不存在的组织 成份构成） Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 临床表现： 儿童，先天性，好发颞下角巩缘 形态： 圆形淡黄色扁平隆起，表面似皮肤 组织，基底粘连，部分病人伴耳部 畸形，脊柱异常。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 治疗： 手术切除或板层角膜移植。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 原位癌（Bowen氏病） 临床表现： 1.老年人，单眼发病，病程慢 2.部位：角巩缘，灰白色半透明隆起 3.可恶变为鳞癌 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 治疗：手术切除，预后好 病理：细胞分裂相多，但上皮细胞基底 膜完好，如癌细胞突破上皮基底膜，则 为鳞癌。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 脉络膜恶性 黑色素瘤 起源于葡萄膜色素细胞 恶性肿瘤，中老年好发。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 临床表现： 分局限性、弥漫性。 肿瘤可发生在周边部和后极部。 后极部： 局限性生长 累及黄斑，出现视力， 变形，暗点。 眼底 隆起呈灰褐色网剥，肿块玻璃体香 蕈样改变 弥漫性生长 早期巩膜蔓延，似中浆，诊断 困难，后期眶内突眼 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 周边部： 多为局限性生长，早期无症状， 瘤体出血玻璃体视力下降， 后期继发青光眼，或坏死眼 球萎缩 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 诊断： 1.主诉+眼底改变 2.B超、CT、MRI、FFA 3.透照试验 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 鉴别： 1.脉络膜转移癌：有原发病灶（乳腺 癌、肺癌、消化道癌等） 眼底：后极网膜灰黄色实质性扁平隆起 2.脉络膜血管瘤：眼底镜下，后极网膜桔 红色圆形隆起。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 视网膜母细胞瘤 Retinoblastoma（RB） 起源于视网膜核层恶性肿瘤，见于3岁 以下儿童，成人偶见。40%遗传性（常 染色体显性）60%非遗传性 遗传者发病早，双眼 非遗传者发病晚，单眼 病机研究：RB的肿瘤抑制基因缺失或失 活，导致了细胞恶变所致。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 临床表现： 白瞳症，斜视，红眼哭吵而就医。 根据发展过程为四期： 1.眼内期：局限于视网膜，玻璃体内。 内生性：肿瘤由视网膜玻璃体，白 瞳明显 外生性：肿瘤向视网膜下发展，为扁 平无孔性网剥视神经生长 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 眼底： 网膜上黄白色肿块，边界不清，伴血管 扩张、出血、网脱 玻璃体混浊 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 2.青光眼期： 肿瘤或新生血管阻塞房角眼压 角膜混，瞳孔大，前房假性积脓 （雪白色） 3.眼外蔓延期： 肿块视神经眶内蔓延眼球突出 或穿破角膜，瘤组织眼外 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 4.转移期： （1）沿视神经颅内 （2）经淋巴全身 （3）经血行骨、肝、肺 最后死亡 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 特殊病人： 1.瘤坏死眼球萎缩 2.若干年第二种恶瘤 病理： 1.未分化型（多见），恶性程度高 2.分化型，恶性程度低 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 诊断与鉴别诊断 诊断： 1.3岁儿童 2.白瞳症、青光眼 3.B超、CT、MRI 4.X线有钙化 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 鉴别： 1.转移性眼内容炎：有感染病史，玻 璃体脓肿，B超无占位。 2.Coast病（渗出性视网膜炎）： 6岁以上男孩，单眼。眼底为视网膜 血管扩张、大片黄白色渗出、出血、 胆固醇结晶。 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 3.ROP（早产儿视网膜病变）：又名晶体 后纤维增生症。有早产吸氧病史，晶体 后有大片灰白不透明纤维血管膜，无钙 化。 4.PHPV（原始玻璃体增生）： 单眼、小眼球，晶体后有致密 灰白色膜 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 治疗： 病灶小，作光凝、冷凝或放疗。范围 广，作眼摘。穿出眼外作眶内容剜出， 加放疗。已转移，联合化疗。 Evaluation only.Evaluation only. Created with Aspose