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Results for “Conjunctival Neoplasms”

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PubMed2003

Detection by impression cytologic analysis of conjunctival intraepithelial invasion from eyelid sebaceous cell carcinoma.

OBJECTIVE: To demonstrate that conjunctival impression cytologic analysis can detect conjunctival intraepithelial invasion from sebaceous cell carcinoma of the eyelid. DESIGN: Observational case series with cytopathologic correlation. PARTICIPANTS: Four patients with unilateral blepharoconjunctivitis and biopsy-proven sebaceous cell carcinoma. METHODS: Impression cytologic analysis specimens were taken from the suspicious area of the bulbar conjunctiva of each patient. Staining of the specimens was performed with a modified Papanicolaou stain. MAIN OUTCOME MEASURE: Observation of the abnormal tumor cells in the collected specimens by bright field microscope. RESULTS: The technique of impression cytologic analysis allowed collection and identification of abnormal tumor cells with characteristic cytoplasmic vacuoles. CONCLUSIONS: Conjunctival impression cytologic analysis successfully detected the ocular surface sebaceous carcinoma cells from the eyelid. However, full-thickness biopsies are necessary to confirm the diagnosis. Judicious use of impression cytologic analysis may facilitate the detection and diagnosis of this invasive tumor.

Adenocarcinoma, Sebaceous↗
PubMed1993

Scleral melt after cryotherapy for conjunctival melanoma.

BACKGROUND: The authors report a patient with a cryotherapy-induced scleral melt after combined excision and cryotherapy of a conjunctival melanoma arising within primary acquired melanosis with atypia. FINDINGS: In a 65-year-old white man, a severe scleral melt developed within 1 month of complete excision of a superficial conjunctival melanoma combined with double-freeze-thaw nitrous oxide cryotherapy to the scleral bed and surrounding conjunctival margins. Ultrasound biomicroscopy showed the degree of scleral thinning. CONCLUSIONS: Although many complications associated with cryotherapy have been described in the literature, there are no reports of a scleral melt. Scleral melt is a potential complication of cryotherapy that can occur despite taking precautions and should be monitored in the first few weeks after cryotherapy to the scleral bed of excised conjunctival tumors.

Aged↗
PubMed1980

Idiopathic acquired melanosis.

Acquired melanosis is the clinical term used to describe a slowly enlarging, diffusely pigmented lesion of the conjunctiva which may also involve the lids, caruncle or cornea. The controversial histologic classifications are reviewed and suggestions made regarding useful and accurate terminology. In acquired melanosis, development of malignant melanoma may occur. Previous work indicates that the prognosis of the resulting melanoma may be assessed by histopathologic staging as is done in cutaneous melanoma. The suggested management of acquired melanosis is close observation with excisional biopsies of areas clinically suggestive of invasive melanomas. Examination of the entire biopsy by serial or staged sections is essential for accurate histopathologic diagnosis. Invasive melanomas have been conventionally treated by local excision or exenteration. Radiation therapy may be a beneficial adjunct.

Adult↗
PubMed1981

Dinitrochlorobenzene immunotherapy of recurrent squamous papilloma of the conjunctiva.

Dinitrochlorobenzene (DNCB) immunotherapy of a recurrent conjunctival papilloma was employed successfully in a 24-year-old man. Previous attempts at electrocautery, surgical excision, and cryosurgery met without success. The tumor response to DNCB therapy resulted in total eradication of the tumor and represents a more successful modality than previous treatments. Poor patient compliance, variable patient immune mechanisms, and tumor size may influence the variable patient immune mechanisms, and tumor size may influence the fate and type of response to DNCb immunotherapy. DNCB therapy should be considered in the treatment of conjunctival papillomas refractory to conventional modes of therapy.

Adult↗
PubMed1981

Fibrous histiocytoma of the corneoscleral limbus: The ultrastructure of a distinctive inclusion.

A case of epibulbar fibrous histiocytoma is presented, with emphasis on the electron microscopic aspects due to the paucity of ultrastructural descriptions of this rare tumor. A tan-yellow conjunctival tumor developed at the corneoscleral limbus in a 31-year-old male. The clinical diagnosis was confirmed by routine histopathologic evaluation, which demonstrated a typical matted or storiform cellular pattern. Electron microscopy revealed a mixed cell population, composed primarily of histiocytic and fibroblastic cells. The histiocytic cells contained lysosomes and phagosomes and had interdigitating cell processes. The fibroblastic cells were characterized by prominent rough-surfaced endoplasmic reticulum and variable amounts of lipid within vacuoles, but did not possess lysosomes or phagosomes. Both cells occasionally contained an unusual curvilinear structure, suggesting a shared histogenesis. This distinctive inclusion appeared to be a modification of the rough-surfaced endoplasmic reticulum. The nature and origin of the tumor cells are discussed on the basis of their ultrastructure.

Adult↗
PubMed1981

Biomicroscopy of papillae associated with hard contact lens wearing.

We studied the macrostructural characteristics of papillary changes of the upper tarsal conjunctiva associated with the wearing of polymethyl methacrylate (PMMA) contact lenses. Fifty subjects with elevated conjunctival papillae greater than 0.3 mm in diameter were studied. Macrostructural characteristics recorded were location, diameter, and number of papillae, presence or absence of staining at the apices of papillae, and degree of hyperemia of the upper tarsal conjunctiva. Patient information collected included age, duration of lens wear, average daily lens wearing time, presence or absence of itching or mucus, refractive status, and atopic history. The tarsal conjunctiva was divided into three zones of equal size. Papillae were present in various zones and combinations of zones; however, papillae were never confined exclusively to either (1) the zone adjacent to the tarsal folds or (2) the latter zone in combination with the zone adjacent to the eyelid margin without also occurring in the intervening zone. The diameter of the papillae ranged from greater than 0.3 mm to 2.0 mm. The number of papillae per eyelid ranged from two to over 100. The apices of the papillae were frequently flattened and craterlike, and often stained with fluorescein.

Adult↗
PubMed1983

Blue nevi of the conjunctiva.

Two examples of conjunctival blue nevi are presented. The clinical and histologic features of these lesions are not in accord with descriptions of blue nevi in the ophthalmic literature. In both cases, the nevi's clinical appearance was brown instead of blue; the nevi could be moved with the conjunctiva over the sclera; and they were not present at birth. Histologically, they demonstrated subepithelial, spindle-shaped melanocytes. The location of the cells was no deeper than that of common acquired compound or subepithelial conjunctival nevi.

Adult↗
PubMed1983

Benign cystic nevus of the conjunctiva.

A 51-year-old white man presented with a large, cystic conjunctival mass along the inferotemporal limbus which was obscuring his vision. Differential diagnosis included benign cystic nevus of the conjunctiva, lymphangioma, lymphangiectasia, and multiple conjunctival inclusion cysts. Biopsy revealed a large cystic nevus of the conjunctiva.

Conjunctiva↗
PubMed1983

Conjunctival myxoma. A clinicopathologic study.

A 54-year-old white man had a slowly growing painless epibulbar mass that clinically mimicked a lymphangioma. Morphologically, the paucicellular tumor contained stellate and spindly cells, mast cells, and dilated lymphatic channels embedded in a loose collagenous matrix. The clinical differential diagnosis included lymphangioma, amelanotic nevus, lymphoma, reactive lymphoid hyperplasia, dermoid, lipoma, and botryoid rhabdomyosarcoma. Pathologically, lymphangioma, myxoid neurofibroma, and spindle cell lipoma were all considered. The authors discuss the clinical and histopathologic features of the various tumors, and confirmation of the diagnosis of conjunctival myxoma by differential alcian blue staining properties dependent on critical electrolyte concentration.

Conjunctiva↗
PubMed1983

Acquired immune deficiency syndrome. Ocular manifestations.

The acquired immune deficiency syndrome (AIDS) is a recently described disorder of cellular immunity in homosexuals, intravenous drug abusers, and Haitians. Manifestations include Kaposi's sarcoma, Pneumocystis carinii pneumonia, and other opportunistic infections. Ophthalmic and autopsy examinations of 30 patients at UCLA revealed frequent ocular abnormalities. Findings included cotton-wool spots (16 patients), cytomegalovirus retinitis (eight patients), conjunctivitis and keratitis (four patients), conjunctival Kaposi's sarcoma (three patients), Mycobacterium avium intracellulare choroidal granulomas (one patient), and retinal periphlebitis (one patient). We feel that the presence of cotton-wool spots in patients with this syndrome indicates a poor prognosis. Immunologic and electronmicroscopic studies of cotton-wool spots revealed no infectious agents or immunoglobulin deposition. Cytomegalovirus retinitis always was associated with a fatal outcome. The retinitis was characterized by an acute inflammatory reaction in 50% of patients. Ophthalmologists should be aware of the syndrome and its ocular manifestations.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Multicentric Kaposi's sarcoma of the conjunctiva in a male homosexual with the acquired immunodeficiency syndrome.

A 38-year-old male homosexual with the new Acquired Immunodeficiency Syndrome (AIDS) had biopsy proven Kaposi's sarcoma of the right palpebral conjunctiva, extraocular mucocutaneous areas, and lymph nodes. Histologically, the palpebral tumor was characterized by atypical spindle cell proliferation and multiple slit-like vessels. Staining for Factor VIII-related antigen was positive in the cytoplasm of some tumor cells. Electron microscopy disclosed Weibel-Palade bodies in cells lining scattered slit-like vascular channels. The palpebral tumor mass was relatively nonadherent to its surrounding tissues and thus its simple excision was noteworthy; despite the prominent vascularity of the tumor, minimal bleeding was associated with its surgical resection. Any patient with AIDS should have all mucosal surfaces routinely examined for the presence of Kaposi's sarcoma lesions.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Conjunctival melanosis and melanoma.

A clinicopathologic study of 41 cases of primary acquired melanosis has provided information concerning the rate of progression to melanoma and has provided histologic parameters useful in predicting which lesions are likely to progress to malignant melanoma. A clinicopathologic study of 131 conjunctival melanomas has provided information concerning the clinical and histologic parameters associated with a fatal outcome. Highlights of these two studies are presented together with implications for diagnosis and therapy.

Cell Transformation, Neoplastic↗
PubMed1985

Acquired immune deficiency syndrome. Pathogenic mechanisms of ocular disease.

A gross, light, and electron microscopic study of the eyes from 35 consecutive autopsy cases of the acquired immune deficiency syndrome revealed cotton-wool spots (71% of cases), retinal hemorrhage in areas without cytomegalovirus infection (40%), cytomegalovirus retinitis (34%) with associated retinal detachment, Roth's spots (23%), retinal microaneurysms (20%), papilledema (14%), conjunctival Kaposi's sarcoma (9%), cryptococcal chorioretinitis (6%), Mycobacterium avium-intracellulare in retina and in choroidal granulomas (6%), ischemic maculopathy (6%), bilateral keratitis (3%), and herpes simplex retinitis (3%). Ocular infection with candida or toxoplasmosis were not found in this autopsy series. Immunocytologic studies demonstrated deposition of immunoglobulins in arteriolar walls, consistent with immune complex mediated disease. Ultrastructural studies showed a vasculopathy in the areas near cotton-wool spots. A mechanism is proposed linking the deposition of immune complexes with subsequent small vessel lesions, ischemia, cotton-wool spots and later spread of cytomegalovirus to retina via damaged vascular endothelium.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Conjunctival involvement with mycosis fungoides in a patient receiving PUVA therapy.

A 40-year-old woman had documented mycosis fungoides of the skin. Over a period of five years, she had undergone intermittent treatment with psoralen long-wave ultraviolet light (PUVA) therapy. Despite regression of the skin lesions, tumor plaques developed in her eyelid and conjunctiva within the area shielded by dark glasses. Light and electron microscopic examination of a biopsy from the conjunctival plaque confirmed that the lesion was a deposit of mycosis fungoides. Local radiotherapy resulted in complete regression of these ocular lesions. The conjunctiva may well be an iatrogenic "sanctuary site" when this disease is treated with PUVA therapy.

Adult↗
PubMed1986

Ocular adnexal monoclonal lymphoid tumors with a favorable prognosis.

Fourteen patients with well- or intermediately differentiated monoclonal B-lymphocytic tumors of the conjunctiva or orbit had a favorable prognosis with follow-ups of 4 to 9 years (mean and median, 7.5 years). The lesions were, for the most part, diffuse proliferations of small lymphocytes, either with round or minimally indented nuclear outlines. Mitotic activity was sparse to nonexistent; occasionally there were scattered small abortive or residual germinal centers, and some lesions exhibited lymphoplasmacytoid features and dispersed multinucleated giant cells (polykaryocytes). None of the six patients with conjunctival lesions had extraocular manifestations. An identical tumor of the submandibular gland developed in one of eight patients with orbital lesions and another patient had multiple extranodal involvements of the oropharynx, liver, and both kidneys, but after chemotherapy the patient has survived for 8 years from orbital presentation and is currently in remission. The authors believe that these low-grade tumors share many biologic resemblances to extranodal lymphoepithelial tumors of other organs (lung, gut, parotid, thyroid), which as a group have been aggregated together as mucosa-associated lymphoid tumors (MALT) and which can often remain localized to their sites of origin.

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↗