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PubMedDate not supplied

A clinicopathologic case report of inflammatory pseudotumors involving the conjunctiva and lung.

BACKGROUND: Inflammatory pseudotumors are characterized histopathologically by aggregates of inflammatory lymphocytes, plasma cells, neutrophils, and fibroblasts. We report a rare case of inflammatory pseudotumor involving both the conjunctiva and lung. CASE: A 58-year-old man with a 6-year history of pulmonary inflammatory pseudotumor was referred to our hospital for evaluation of conjunctival swelling in the left eye and bilateral iritis. OBSERVATIONS: The subconjunctival tumor enlarged slowly, but regressed spontaneously. After partial resection of the subconjunctival and lung tumors, the presence was confirmed of aggregates of chronic inflammatory cells (lymphocytes, plasma cells, neutrophils, fibroblasts) without noncaseating epithelioid granuloma formation. Gene rearrangement testing ruled out malignancy. The patient was treated with oral corticosteroids for fever and primary biliary hepatic cirrhosis. Iritis signs subsided slightly in response to corticosteroids, but persisted. The temporal subconjunctival pseudotumor resolved without recurrence. CONCLUSIONS: This case was compatible histopathologically with inflammatory pseudotumor, and is a rare case of simultaneous occurrence in the lung and conjunctiva.

Conjunctival Neoplasms↗
PubMed1989

Long-term results of cryotherapy on malignant epithelial tumors of the conjunctiva.

We studied the results of combined treatment with excision and cryotherapy with the nitrous oxide probe in 22 eyes of 20 patients with intraepithelial tumors or squamous cell carcinomas of the conjunctiva. Patients were followed up for five to 12 years. Only two recurrences (9%) were seen, both of which occurred within the first two years. Over the long term, excision combined with cryotherapy decreased the recurrence rate of intraepithelial tumors and squamous cell carcinomas of the conjunctiva.

Adult↗
PubMedDate not supplied

Invasive squamous cell carcinoma of the conjunctiva presenting as necrotizing scleritis with scleral perforation and uveal prolapse.

A 64-year-old white man presented with necrotizing scleritis with scleral perforation and uveal prolapse. Pathologic examination revealed squamous cell carcinoma of the conjunctiva invading adjacent corneal stroma and ciliary body. Invasive squamous cell carcinoma of the conjunctiva is uncommon, and intraocular invasion has rarely been reported in the literature.

Carcinoma, Squamous Cell↗
PubMed1994

The detection of petechial haemorrhages of the conjunctivae in dependency on the postmortem interval.

Petechial haemorrhages of the conjunctivae are not specific for lethal throttling or strangulation, but they belong to the important indicators for such mechanisms. In experimental models it is shown that petechial bleedings of the conjunctivae disappear with the occurrence of advanced signs of putrefaction or in cases of fresh-water logging. Therefore, it must be emphasized that the lack of petechial haemorrhages in putrefied or fresh-water-logged corpses is of very restricted meaning for the examination, whether throttling or strangulation has taken place or not, and the autopsy should always be performed in these cases with special regard to the neck.

Asphyxia↗
PubMed2005

Papillomavirus infection in the conjunctiva of individuals with and without AIDS: an autopsy series from Uganda.

HIV and genus beta human papillomavirus (HPV) types have been associated with squamous cell carcinoma of the conjunctiva (SCC). To determine whether conjunctival HPV infection is associated with AIDS, we analysed 136 lesion-free eye biopsies and tested for genera alpha, beta and gamma HPV types. Only infections with genera beta and gamma HPV types was found. After adjustment for age and gender, no excess of genera beta or gamma HPV infection was found in individuals who had died of or with AIDS compared to those who had died of other infectious diseases [relative risk (RR)=1.3; 95% confidence interval (CI): 0.4-4.8], or chronic diseases or trauma (RR=0.9; 95% CI: 0.3-2.9). Our findings suggest that infection with genera beta or gamma HPV types in lesion-free conjunctivas is common, but not greatly enhanced by the presence of AIDS.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Tumors of the conjunctiva and cornea.

Tumors of the conjunctiva and cornea comprise a large and varied spectrum of conditions. These tumors are grouped into two major categories of congenital and acquired lesions. The acquired lesions are further subdivided based on origin of the mass into surface epithelial, melanocytic, vascular, fibrous, neural, histiocytic, myxoid, myogenic, lipomatous, lymphoid, leukemic, metastatic and secondary tumors. Melanocytic lesions include nevus, racial melanosis, primary acquired melanosis, melanoma, and other ocular surface conditions like ocular melanocytosis and secondary pigmentary deposition. The most frequent nonmelanocytic neoplastic lesions include squamous cell carcinoma and lymphoma, both of which have typical features appreciated on clinical examination. The caruncle displays a slightly different array of tumors compared to those elsewhere on the conjunctiva, as nevus and papilloma are most common, but oncocytoma and sebaceous gland hyperplasia, adenoma, and carcinoma can be found. In this report, we provide clinical description and illustration of the many conjunctival and corneal tumors and we discuss tumor management.

Conjunctival Neoplasms↗
PubMed1989

Malignant melanomas of the conjunctiva, nasal cavity, and paranasal sinuses.

Four patients had malignant melanoma involving the conjunctiva, nasal cavity, and paranasal sinuses. In each patient, the conjunctival melanoma preceded recognition of the lesion in the nasal cavity by months or years. Each patient had one or more conjunctival biopsy specimens that documented melanoma, and in each patient the melanomas evolved in primary acquired melanosis of the conjunctiva. Histologic examination of the epithelium adjacent to the tumor in the nasal cavity failed to show either atypia or diffuse melanosis. We believe that these melanomas in the nasal cavity and paranasal sinuses are most likely to evolve as regional metastases, although it is possible that they arise de novo or as related foci in accordance with the multicentric characteristics of conjunctival melanoma. If a patient with a conjunctival melanoma has symptoms referable to the nasal cavity or paranasal sinuses, ophthalmologists should refer the patient to an otolaryngologist.

Conjunctival Neoplasms↗
PubMed1999

Renal cell carcinoma with involvement of iris and conjunctiva.

PURPOSE: To report a case of metastatic renal cell carcinoma with involvement of the iris and bulbar conjunctiva. METHODS: Case report. A 70-year-old man without known systemic disease developed an iris mass in his left eye. Iridocyclectomy was performed to remove the iris mass. RESULTS: Histopathologically, the iris mass was consistent with metastatic renal cell carcinoma. Further evaluation disclosed a mass of the left kidney. The patient underwent a left nephrectomy and was found to have renal cell carcinoma, with focal penetration into the renal capsule. One month after the nephrectomy, he developed a highly vascular nodule of the left bulbar conjunctiva. An excisional biopsy was performed, and histopathology disclosed an additional focus of renal cell carcinoma. CONCLUSIONS: Iris and conjunctival involvement may be a clinical manifestation of renal cell carcinoma. Renal cell carcinoma should be considered in the differential diagnosis of a fleshy, vascular iris and a conjunctival nodule.

Aged↗
PubMedDate not supplied

The role of Branhamella ovis, Mycoplasma conjunctivae and Chlamydia psittaci in conjunctivitis of sheep.

Smooth (S) and rough (R) types of Branhamella ovis were used alone and in conjunction with Mycoplasma conjunctivae and Chlamydia psittaci in attempts to produce conjunctivitis in lambs. This was only successful with one S-type previously isolated from a clinical case of conjunctivitis. In experimental mixed infection, B. ovis contributed to the severity of ovine keratoconjunctivitis attributable to infection with Mycoplasma conjunctivae. When B. ovis and C. psittaci were inoculated into the conjunctival sac mild conjunctivitis was produced but C. psittaci could not be re-isolated.

Animals↗
PubMedDate not supplied

Fornix and conjunctiva reconstruction by amniotic membrane in a patient with conjunctival mucosa-associated lymphoid tissue lymphoma.

BACKGROUND: Conjunctival mucosa-associated lymphoid tissue (MALT) lymphoma is a rare, low-grade, non-Hodgkin's B-cell lymphoma. Herein, we report our successful management of the large conjunctival defect caused by resection of conjunctival MALT lymphoma by covering it with transplanted amniotic membrane. CASE: A 28-year-old Japanese man, who had been diagnosed histologically as having conjunctival MALT lymphoma in his left eye, was referred to us for treatment. The tumor was located on the lower bulbar and palpebral conjunctiva, and involved the fornix. Extensive resection of the conjunctival lesion was performed. Two pieces of amniotic membrane were used to reconstruct the fornix, bulbar, and palpebral conjunctival defect. OBSERVATIONS: Epithelialization over the transplantation was completed within 3 weeks when all sutures were removed. During the 6 months of follow-up, there was no recurrence or any postoperative complication, such as graft rejection, symblepharon, or chronic inflammation. CONCLUSIONS: We demonstrated for the first time that amniotic membrane can be used to cover a large defect on both bulbar and palpebral conjunctiva when such a low-grade malignancy as MALT lymphoma is extensively excised. Amniotic membrane transplantation was quite effective for the fornix and conjunctival reconstruction.

Adult↗
PubMed2001

Sclerokeratitis: an unusual presentation of squamous cell carcinoma of the conjunctiva.

OBJECTIVE: To describe three cases of squamous cell carcinoma of the conjunctiva presenting with corneal and scleral inflammation, thinning, and perforation without any tumor formation. DESIGN: Three case reports. PARTICIPANTS: Three male subjects aged 76, 66, and 61 years. INTERVENTION: The subjects had symptoms of external ocular inflammation with focal corneal or scleral thinning and inflammation, as well as interstitial keratitis in two cases. Initial diagnosis of sclerokeratitis with limbal thinning was made in all three in addition to a pterygium in case 2. MAIN OUTCOME MEASURES: Diagnosis of the carcinoma was delayed for 2 to 24 months in two cases, whereas case 2 was diagnosed on excision of a pterygium from the involved area. RESULTS: All subjects developed intraocular extension after further scleral thinning and perforation without tumefaction. CONCLUSIONS: Squamous cell carcinoma of the conjunctiva may be seen without a distinct mass and can masquerade as sclerokeratitis, scleromalacia, or interstitial keratitis. It seems that diffuse growth with inflammation leads to thinning, necrosis, and perforation of the ocular wall with resultant intraocular spread. Squamous cell carcinoma should be considered in the differential diagnosis of corneal and scleral thinning, perforation, and inflammation of unknown cause, especially in the older male subject.

Aged↗
PubMed1986

Treatment of recurrent squamous papillomata of the conjunctiva by carbon dioxide laser vaporization.

Complete resection of recurrent conjunctival squamous papillomata frequently may be exceedingly difficult, since such lesions are typically friable and multilobulated. Recurrent lesions often fill the fornicies and spill onto the lid margins. Moreover, since the human papillomavirus (HPV) has been linked to some of these lesions, there remains the further possibility of spread with "cold knife" resection. We discuss the benefits of carbon dioxide laser vaporization therapy for recurrent squamous papillomata of the conjunctiva that have not responded to resection and cryotherapy or topical immunotherapy. The carbon dioxide laser facilitates resection by providing a bloodless field, and reduces the possibility of viral seeding of the conjunctiva by sterilizing the operative site and sealing the lymphatics.

Adult↗
PubMed1991

Leiomyosarcoma of the conjunctiva.

The clinical, light microscopic, immunohistologic, and ultrastructural findings of a leiomyosarcoma of the conjunctiva are presented. This tumor was diagnosed after a 26-year history and is the first to be adequately documented as having arisen in the conjunctiva.

Aged↗
PubMed2000

Pigmented spindle cell naevus of reed presenting in the conjunctiva.

PURPOSE: This study aimed to present the clinical and histopathological features of a pigmented spindle cell naevus (PSCN) appearing in the conjunctiva. METHODS: Histopathological examination of the lesion following excision and review of the pertinent literature. RESULTS: The features were consistent with those previously recognized in the skin as the PSCN of Reed. CONCLUSION: The PSCN can appear in the conjunctiva and should not be confused with conjunctival melanoma.

Biomarkers, Tumor↗
PubMed1992

Primary lymphoplasmacytoma of the conjunctiva.

We report the case of an 80-year-old patient with isolated lymphoplasmacytoma of the conjunctiva. Only five other such cases have been previously reported in the literature. In all six patients, the disease remained limited and no sign of systemic disease could be found after prolonged follow-up. As isolated plasmacytoma of the conjunctiva seems to be benign, treatment of such tumours should be conservative.

Aged↗
PubMed2001

Differential immunoreactivity of melanocytic lesions of the conjunctiva.

AIMS: To evaluate the expression of S100NKI/C3 and HMB45 antigens in melanocytic lesions of the conjunctiva and the ability of HMB45 to aid assessment of neoplasia. METHODS AND RESULTS: Stored formalin-fixed specimens of conjunctival melanomas and primary acquired melanosis were considered as participants and conjunctival naevi and racial melanosis as controls. Ninety-seven conjunctival melanocytic lesions were analysed using formalin-fixed paraffin-embedded material. These included 20 melanomas arising in the context of primary acquired melanosis (PAM), 22 melanomas arising without evidence of pre-existing PAM, seven cases of PAM with atypia, nine cases of PAM with no atypia, 35 conjunctival naevi and four cases of racial melanosis. S100 and NKI/C3 were similarly expressed in all lesions, with at least one of these markers positive in 100% of the lesions examined. HMB45 was expressed in 72.7% of primary melanomas and 85% of melanomas in the context of PAM; 42.8% of PAM with atypia expressed HMB45 while it was expressed in 11.1% of PAM without atypia and 8.5% of naevi. Racial melanosis cases did not express HMB45. S100 and NKI/C3 were expressed to a similar extent in all groups. CONCLUSIONS: S100 and NKI/C3 are useful markers to assess the extent of melanocytic lesions in the conjunctiva. HMB45 immunoreactivity can act as a useful aid to histopathology for the distinction of benign from malignant conjunctival lesions, particularly in the context of primary acquired melanosis.

Antigens, Neoplasm↗
PubMed1997

[Solitary extramedullary plasmacytoma of the conjunctiva].

UNLABELLED: Unpigmented tumorous changes of the conjunctiva can frequently be classified as chalazion, basalioma or carcinoma. PATIENT AND METHODS: In a 70 years old diabetic female a 2.5 x 2.5 cm tumor of the lower conjunctival fornix was observed. After complete excision the tumor was examined by histologic routine procedures and immunohistochemically. The patient was irradiated by 40 Gy with the linear accelerator. RESULTS: The monotypical secretion of the heavy chain gamma and the light chain kappa demonstrated a well differentiated extramedullar plasmocytoma. A MALT lymphoma could be excluded by the absence of centrocytoid cells. The bone cytology and histology did not give any evidence for a medullar plasmocytoma. The patient is free from local or diffuse tumor growth since 2 1/2 years. CONCLUSION: Since the worldwide most important ophthalmopathologic statistics of the AFIP from 1984-1989 describes only 1 plasmocytoma out of 2104 tumors of the lids and conjunctiva, the demonstrated case is an important rarity.

Aged↗
PubMed1994

[Combined surgery, cryocoagulation and radiotherapy for treatment of melanoma of the conjunctiva].

BACKGROUND: Conjunctival melanomas are malignant tumors with a high local recurrence rate after simple surgical excision. The rate of recurrence is particularly high in cases of large size tumor, of widespread tumors and with PAM associated lesions. Tumor recurrences have a bad long-term prognostic significance and often necessitate exenteration. PATIENTS AND METHODS: A method of therapy combining total surgical excision with proton-beam irradiation, cobalt plaque irradiation and cryotherapy is described. This technique is used in particular unfavorable cases with the aim of lowering the rate of recurrences. It was practiced in 19 cases in Lausanne, 10 of which were recurrent tumors. The melanoma invaded 3 quadrants of the bulbar conjunctiva in 8 cases and 4 quadrants in 11 cases. At least one neighbouring tarsal conjunctiva was invaded in 11 cases and both in 7 cases. The skin of the eyelid was infiltrated in 6 cases and the caruncle in 9 cases. Tumor thickness was 1 to 2 mm in 8 cases, 3 to 4 mm in 4 cases and 5 to 10 mm in 7 cases. RESULTS: PAM was present in 16 cases. Follow-up period was less than 1 year in 2 cases, between 1 to 2 years in 5 cases, between 2 to 3 years in 5 cases and more than 3 years in 7 cases. 5 patients had lymph node metastases, 3 died of metastatic disease and 2 had a local recurrence. One of these recurrences was small-sized and was excised, the other was widespread and the patient died soon with metastatic disease. No exenteration was performed. CONCLUSION: The method of therapy that is here described appears to be a valuable alternative to exenteration of the orbit for the treatment of diffuse or large-size conjunctival melanomas which have a high risk of local recurrence.

Adult↗