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PubMed1999

Cytologic and DNA cytometric diagnosis and therapy monitoring of squamous cell carcinoma in situ and malignant melanoma of the cornea and conjunctiva.

OBJECTIVE: To investigate the diagnostic accuracy of exfoliative cytology of the cornea and conjunctiva and DNA image cytometry for quality control and monitoring of therapy for malignant neoplasms. STUDY DESIGN: Conjunctival or corneal smears from six cases clinically suspicious for malignant melanomas and eight suspicious for carcinomas in situ were investigated. Smears from 18 cases clinically nonsuspicious for neoplastic diseases served as negative controls. Repeated smears were obtained during and after local mitomycin C (MMC) therapy. RESULTS: In none of 18 nonsuspicious cases, cytology revealed abnormal cells. DNA cytometry showed nonaneuploidy in all of these. All smears from patients with histologically proven malignant melanomas (MM) and squamous cell carcinomas in situ revealed abnormal cells. Image cytometry demonstrated DNA aneuploidy in 66.6% of patients with MM and 80% with carcinoma. Sensitivity of cytology thus was 100% for both MM and carcinoma; specificity also was 100%. DNA measurements after MMC therapy revealed euploid polyploidization of nonneoplastic squamous cells. DNA cytometry provided an objective identification of tumor cell regression. CONCLUSION: Cytologic examination of corneal and conjunctival smears is a noninvasive tool with high diagnostic accuracy for detection of epithelial neoplasms. DNA image cytometry can serve for quality control and for objective monitoring of the effect of local chemotherapy.

Aneuploidy↗
PubMed2000

[Bacterial infection in the conjunctiva of patients with adenoviral conjunctivitis].

PURPOSE: We evaluate the microbiological features of mixed infection in adenovirus-infected conjunctiva. SUBJECTS: Isolation of bacteria was performed in 82 samples of adenoviral conjunctivitis at six eye clinics in Japan. METHODS: For microbiological diagnosis, we performed immunochromatography (IC) and polymerase chain reaction--restriction fragment length polymorphism (PCR-RFLP) analysis for detection and serotyping of adenovirus, and PCR for detection of herpes simplex virus (HSV) and Chlamydia trachomatis antigens out of 82 samples with adenoviral conjunctivitis. RESULTS: Pathogenic bacteria were isolated in 6 samples out of 82. Out of these 6 cases, 5 samples were gram-negative rods and most of them were Flavobacterium meningosepticum (4 samples). Adenovirus type 8 was isolated from all these mixed infection cases. However, HSV-1 and Chlamydia trachomatis were not found. CONCLUSIONS: From these results, it is suggested that gram-negative rods, especially F. meningosepticum, are the most common bacteria causing mixed bacterial infection in adenoviral conjunctivitis.

Adenovirus Infections, Human↗
PubMed2001

Solitary keratoacanthoma of the conjunctiva: report of a case.

Keratoacanthoma characteristically occurs on the skin and is rarely found in the conjunctiva. We, herein, report a case of a healthy 41-year-old Thai woman presenting with a rapidly growing conjunctival mass. The tumor was excised to exclude squamous cell carcinoma. Histopathology revealed a cup shaped well-circumscribed proliferation of squamous cells, with a central keratin crater, consistent with a keratoacanthoma. On the literature review, only 12 cases have previously been reported in the English language. The mean age of presentation was 40.75 years, with a male preponderance. Presentation of a mass was mostly within 4 weeks after onset. History of foreign material getting into the eye was positive in 5 cases. All cases were successfully treated by excision, except for one case in which malignancy transformation was found, and enucleation was required eventually. Conjunctival keratoacanthoma is a rare disease. However, this lesion should be well recognized and not misinterpreted as malignancy. As far as we are aware, this is the first report of conjunctival keratoacanthoma from this region.

Adult↗
PubMed2000

Invasive squamous cell carcinoma of the conjunctiva.

A 75-year-old man, known with Morbus Kahler, was referred with a history of uveitis and hypopyon at the left eye. The uveitis did not respond to any steroid treatment. It was complicated with high intraocular pressure. Anterior chamber punction showed atypical cells of epithelial origin. Several weeks prior to this presentation an atypical pterygium of the same eye was biopsied. Histopathologic examination at that time showed mild atypical actinic changes. The biopsy specimen was reviewed in our laboratory and revealed an invasive squamous cell carcinoma originating from the bulbar conjunctiva. The eye was eventually enucleated. Histologic examination of the enucleated eye showed invasion of the cornea, sclera, trabeculum, anterior chamber angle and choroid by a muco-epidermoid squamous cell carcinoma.

Aged↗
PubMed2003

[Pigmentary tumors of the conjunctiva in children: analysis of surgical decision].

Pigmentary tumors of the conjunctiva are rare in children, but they deserve special attention as, under some circumstances, they can question the quo ad vitam prognosis. The management of these tumors is controversial because the clinical diagnosis is uncertain, not reliable for a long term evolution prognosis. In this study, after a short review of the literature, the authors present their own experience in the field (47 cases during the last 10 years, out of which 18 underwent surgery) and they try to develop an algorithm of surgical decision based on age-related factors, clinical appearance, aesthetic factors and on the possibility of establishing a good relationship with the patient and the family.

Adolescent↗
PubMed1991

Malignant fibrous histiocytoma of the skin and the conjunctiva in xeroderma pigmentosum.

Patients with xeroderma pigmentosum (XP) experience cutaneous and ocular abnormalities, including neoplasia of epithelial and melanocytic cellular origin. Black patients with XP display more severe ocular abnormalities and neoplasia. We report the clinicopathologic findings in two black young children with XP who presented with malignant fibrous histiocytoma (one of the conjunctiva and the other one of the skin of the face). These appearances of malignant fibrous histiocytoma at an unusually early age and in rare locations are, to our knowledge, the first to be reported in XP and go along with the special characteristics of XP: frequent occurrence of tumors on exposed parts of the body at a very early age.

Child, Preschool↗
PubMed2006

Conjunctiva philophthalmosis: a case report in Thailand.

A 31-year-old Thai woman, a resident of Mapthaphut, Rayong Province, eastern Thailand, attended Rayong Provincial Hospital after suffering from consistent irritation of the eye for 5 days. Examination conducted by an ophthalmologist revealed a small worm moving on the conjunctiva of the right eye. The worm was removed and sent for identification. It was 2.9 mm in length, elongated oval, pharynx very large, ceca end close to the excretory pore, genital pore opens in front of the ventral sucker at the cecal bifurcation; it was identified as Philophthalmus sp., a trematode that parasitizes the eyes of birds. This is the first human case of Philophthalmus infection in Thailand.

Adult↗
PubMed2005

[The comparison of HE staining and giemsa staining in detection of eosinophilic granulocytes in conjunctiva scroping].

PURPOSE: To find the better method of eosinophilic granulocytes staining by comparison between HE staining and Giemsa staining METHODS: Twenty conjunctivitis patients(40 eyes) were studied. The infected palpabral conjunctiva of both eyes were scroped and stained separately with Giemsa staining and HE staining. RESULT: Under microscope, eosinophilic granulocytes were more clear by Giemsa staining than HE staining. CONCLUSION: In showing eosinophilic granulocytes, Giemsa staining was better than HE staining.

Azure Stains↗
PubMedDate not supplied

Chlamydia-specific lymphocytes in conjunctiva during ocular infection: limiting dilution analysis.

The immunopathogenesis of ocular infection with Chlamydia trachomatis can be investigated in the cynomolgus monkey model of trachoma. During ocular infection, both follicles (germinal centers) containing primarily B lymphocytes and a heavy perifollicular T cell infiltrate are observed. Limiting dilution analyses were performed on conjunctival and peripheral blood lymphocytes to quantify the proportion of antigen-specific cells elicited by ocular C. trachomatis infection. The frequencies of chlamydia-specific cells were 10-100 times higher in conjunctiva than in peripheral blood. Similar frequencies were observed during active infection and during the ocular delayed hypersensitivity response elicited in sensitized monkeys by topical challenge with a triton X-100 extract containing the 57 kD chlamydial stress protein. Given the antigen-specific proliferative response, these cells are most likely T lymphocytes. The finding of large numbers of antigen-specific conjunctival lymphocytes at the site of chlamydial infection suggests that they play an important role in the pathogenesis of this potentially blinding disorder.

Animals↗
PubMed1991

[Mucoepidermoid carcinoma of the conjunctiva with intraocular invasion. Apropos of a case].

One case of mucoepidermoid carcinoma of the conjunctiva with intraocular invasion is described. Review of literature retrieve 15 cases of conjunctival localisation of mucoepidermoid carcinoma. These tumors appear to be locally aggressive, they all invade the intraocular or intraorbital structures. They require always a radical surgery with wide excision. Histopathologically, histochemical stains for glycoproteins confirm the diagnosis with admixture of squamous and mucus secreting cells.

Aged↗
PubMed1991

Primary acquired melanosis of the conjunctiva is melanoma in situ.

This essay places the concept of "primary acquired melanosis" of the conjunctiva in historical perspective and shows that it and its analogs, namely, lentigo-melanosis (Hutchinson), melanotic freckle (Hutchinson), melanose circonscrite precancereuse (Dubrueilh), melanotische precancerose (Miescher), lentigo maligna (Clark), precancerous melanosis (Reese), benign, precancerous, and cancerous melanosis (Zimmerman), atypical melanocytic hyperplasia (Silver et al.), and benign acquired melanosis (Zimmerman), are synonyms for melanoma in situ. The issue is not merely semantic or philosophical; it is urgently practical. If a clinician takes literally the meaning of a lesion designated "benign melanosis" and considers it to be benign, rather than the malignant melanoma that it actually is, a patient who bears that flat pigmented lesion may one day die of metastasis from an elevated sequella of it. The same is true of "primary acquired melanosis," which is not simply a condition of blackening by melanin, but a flat melanoma that, if not removed completely, may give rise one day to metastases that cause death. To avoid such misconstructions, we advocate naming melanomas in all organs "melanoma" and those that are confined to epithelial structures "melanoma in situ." Euphemisms like lentigo maligna and primary acquired melanosis are evasions of the diagnosis of melanoma, and use of them may be harmful. For that reason, they should be eschewed.

Conjunctival Neoplasms↗
PubMed1990

Histological types of spindle cell carcinoma of the cornea and conjunctiva. A clinicopathologic report of 8 patients with ultrastructural and immunohistochemical findings in three tumors.

We analysed the clinical and pathological features of 8 patients with spindle cell carcinoma of the conjunctiva and/or cornea. Four tumors arose from the cornea of atrophic eyes that had previous corneal ulcers. The tumors could be divided into 3 types according to their histopathological findings: fibrosarcomatous type, fibro-histiocytomatous type, and rhabdomyosarcomatous type. The 8 patients were misdiagnosed clinically and pathologically. Careful retrospective histopathologic examination using serial sections and in some tumors the addition of ultrastructural and immunohistochemical studies revealed the correct diagnosis. Follow-up data were obtained in 5 patients. Four of them were alive for 20, 10, 3, and 2 years respectively after surgery. One conjunctival tumor recurred 10 months after local excision.

Aged↗
PubMed1990

A complex choristoma of the conjunctiva.

The choristoma belongs to marginal problems in ophthalmology, nevertheless it is not negligible, and in the differential diagnosis of the tumors of the conjunctiva and the cornea we must take it into consideration especially in connection with the potential possibility of its malignant progression. The finding of a choristoma may signal a simultaneous occurrence of other lesions of an analogous origin in other localities than that of the bulbus or the orbit, which should lead the ophthalmologist to a complex examination of the patient and an interdisciplinary cooperation with the neurologist, oto-rhino-laryngologist, dermatologist, and others.

Child↗
PubMed1990

[Malignant melanoma of the conjunctiva].

The authors analyze six cases with malignant melanoma of the conjunctiva treated at the Ophthalmological Clinic in Brno in 1967-1988. They evaluate contemporary therapeutic possibilities and results of treatment. The prognosis of the condition is in general more favourable than in malignant melanomas of other mucous membranes.

Adolescent↗
PubMed1989

Spindle cell carcinoma of cornea and conjunctiva with pseudosarcomatous metaplasia. Light microscopic, electron microscopic and immunohistochemical findings in 2 patients.

We studied the electron microscopic and immunohistochemical findings in two elderly patients with spindle cell carcinoma of the cornea and conjunctiva. By light microscopy, correct diagnosis was made by finding the transition between the pleomorphic spindle shaped tumor cells and the overlying squamous epithelium. Ultrastructural findings indicated that squamous cell origin included tonofilament-associated desmosomes and keratohyaline granules in the tumor cells. Positive immunohistochemical staining with antikeratin antibodies provided further evidence to prove the origin of spindle cell carcinoma. Follow-up of the two patients showed the malignant tumor to be quite aggressive in terms of intraocular invasion in the first patient and local recurrence in the second.

Carcinoma↗
PubMed1989

A subepithelial elastic lamina in the palpebral conjunctiva of monkeys.

Eyelids from ten cynomolgus monkeys were sectioned in a variety of orientations and the conjunctival layer examined by light and electron microscopy. An elastic lamina composed of a mesh of mature elastic fibres was present in the palpebral conjunctival stroma adjacent to the epithelium covering the area of the tarsal plate and extending to the lid margin. Mesh fibres orientated at or close to right angles to the lid margin were thicker and denser than the transverse and oblique fibres linking them. The elastic lamina was most substantial in the marginal conjunctiva bridging the interval between the tarsal plate and the mucocutaneous junction where it terminated abruptly. In this position the area occupied by the elastic mesh exceeded that of the mesh spaces. Dense collagen bundles enclosed the lamina, infiltrating the mesh spaces and attaching the lamina firmly to the tarsal plate. In the marginal zone thick elastic fibres branched forward from the lamina in a brush-like fashion penetrating the relatively soft marginal eyelid tissue obliquely between tarsal gland ducts, while other finer, more numerous fibrils passed backwards attaching the lamina to the basement membrane of the epithelium. The organisation of the elastic lamina suggests that the tension generated would act to pull the lid margins towards the surface of the eye. Production of a regular thin tear film during lid retraction following a blink is facilitated by this action.

Animals↗