1
|
Nemoto R, Usui Y, Komatsu H, Tsubota K, Sugawara R, Nagao T, Goto H. Immunophenotypic profiles in chalazion and pyogenic granuloma associated with chalazion. Graefes Arch Clin Exp Ophthalmol 2024; 262:1329-1335. [PMID: 37934292 DOI: 10.1007/s00417-023-06304-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/25/2023] [Accepted: 10/23/2023] [Indexed: 11/08/2023] Open
Abstract
PURPOSE To evaluate immunophenotypic profiles of infiltrating cells in surgically excised tissues of chalazion and pyogenic granuloma associated with chalazion. METHODS Eighty-two surgical specimens from 74 consecutive patients newly diagnosed with chalazion or chalazion-associated pyogenic granuloma at Tokyo Medical University Hospital between 2016 and 2022 were studied. Sixty specimens were chalazion lesions and 22 specimens were pyogenic granuloma lesions (from 15 men and 7 women, mean age 36.6 ± 14.4 years). All patients were immunocompetent Asian Japanese adults. Specimens were analyzed by immunohistochemistry and flow cytometry. Flow cytometry was performed using the following antibodies: CD3, CD4, CD8, CD11b, CD11c, CD16, CD19, CD20, CD23, CD25, CD34, CD44, CD56, CD69, and CD138. RESULTS In flow cytometric analysis, the proportion of cells expressing the T cell marker CD3 was significantly higher compared with other immune cells expressing specific markers (p < 0.0001), and the proportion of CD4-positive T cells was significantly higher than that of CD8-positive T cells (p < 0.0001), in both chalazion and pyogenic granuloma specimens. The chalazion and pyogenic granuloma lesions shared similar immunophenotypic profile characterized by predominant T cell infiltration, and CD4 T cells dominating over CD8 cells. The pattern of expression of CD4 and CD8 in the specimens was confirmed by immunohistochemistry. CONCLUSION The present study demonstrates immunophenotypic features of chalazion and chalazion-associated pyogenic granuloma. Although various inflammatory cells are involved in the pathology of chalazion and pyogenic granuloma, a significantly higher proportion of CD4-positive T cells may be closely related to the pathological mechanisms of both lesions.
Collapse
Affiliation(s)
- Rey Nemoto
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-Ku, Tokyo, Japan
| | - Yoshihiko Usui
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-Ku, Tokyo, Japan.
| | - Hiroyuki Komatsu
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-Ku, Tokyo, Japan
| | - Kinya Tsubota
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-Ku, Tokyo, Japan
| | - Risa Sugawara
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-Ku, Tokyo, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-Ku, Tokyo, Japan
| | - Hiroshi Goto
- Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-Ku, Tokyo, Japan
| |
Collapse
|
2
|
Mahjoub A, Zaafrane N, Chaabene R, Ben Abdesslem N, Sellem I, Allagui O, Jouini A, Ben Said M, Ghorbel M, Mahjoub H. [Pyogenic granuloma: Clinical, etiological and therapeutic features. A series of five cases]. J Fr Ophtalmol 2023; 46:e230-e233. [PMID: 37442691 DOI: 10.1016/j.jfo.2023.01.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 01/07/2023] [Accepted: 01/26/2023] [Indexed: 07/15/2023]
Affiliation(s)
- A Mahjoub
- Service d'ophtalmologie, CHU Farhat Hached de Sousse, rue Ibn El Jazzar, 4000 Sousse, Tunisie; Faculté de médecine de Sousse, université de Sousse, 4000 Sousse, Tunisie
| | - N Zaafrane
- Service d'ophtalmologie, CHU Farhat Hached de Sousse, rue Ibn El Jazzar, 4000 Sousse, Tunisie; Faculté de médecine de Sousse, université de Sousse, 4000 Sousse, Tunisie
| | - R Chaabene
- Service d'ophtalmologie, CHU Farhat Hached de Sousse, rue Ibn El Jazzar, 4000 Sousse, Tunisie; Faculté de médecine de Sousse, université de Sousse, 4000 Sousse, Tunisie.
| | - N Ben Abdesslem
- Service d'ophtalmologie, CHU Farhat Hached de Sousse, rue Ibn El Jazzar, 4000 Sousse, Tunisie; Faculté de médecine de Sousse, université de Sousse, 4000 Sousse, Tunisie
| | - I Sellem
- Service d'ophtalmologie, CHU Farhat Hached de Sousse, rue Ibn El Jazzar, 4000 Sousse, Tunisie; Faculté de médecine de Sousse, université de Sousse, 4000 Sousse, Tunisie
| | - O Allagui
- Service d'ophtalmologie, CHU Farhat Hached de Sousse, rue Ibn El Jazzar, 4000 Sousse, Tunisie; Faculté de médecine de Sousse, université de Sousse, 4000 Sousse, Tunisie
| | - A Jouini
- Service d'ophtalmologie, CHU Farhat Hached de Sousse, rue Ibn El Jazzar, 4000 Sousse, Tunisie; Faculté de médecine de Sousse, université de Sousse, 4000 Sousse, Tunisie
| | - M Ben Said
- Service d'ophtalmologie, CHU Farhat Hached de Sousse, rue Ibn El Jazzar, 4000 Sousse, Tunisie; Faculté de médecine de Sousse, université de Sousse, 4000 Sousse, Tunisie
| | - M Ghorbel
- Service d'ophtalmologie, CHU Farhat Hached de Sousse, rue Ibn El Jazzar, 4000 Sousse, Tunisie; Faculté de médecine de Sousse, université de Sousse, 4000 Sousse, Tunisie
| | - H Mahjoub
- Service d'ophtalmologie, CHU Farhat Hached de Sousse, rue Ibn El Jazzar, 4000 Sousse, Tunisie; Faculté de médecine de Sousse, université de Sousse, 4000 Sousse, Tunisie
| |
Collapse
|
3
|
Bin Dlaim MS, Alhussein GA, Alqahtani RS, Almanea LT. Conservative Management of Giant Pyogenic Granuloma Post Strabismus Surgery: A Case Report and Literature Review. Cureus 2023; 15:e41321. [PMID: 37539417 PMCID: PMC10395757 DOI: 10.7759/cureus.41321] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2023] [Indexed: 08/05/2023] Open
Abstract
Ocular pyogenic granuloma is a benign vascular tumor that occurs primarily in children. Treatment options for pyogenic conjunctival granulomas include topical steroids, topical timolol, surgery, cryotherapy, and electrocautery. Patients with giant pyogenic granulomas are usually treated with surgical intervention. In this case, a 13-year-old Egyptian girl developed a giant pyogenic granuloma after strabismus surgery. Topical steroids showed a poor response and failed to demonstrate any improvement. While on timolol, the granuloma completely regressed, with no signs of recurrence. Despite the usual surgical approach to the treatment of purulent giant granulomas, we believe that topical timolol can be the preferred option as a noninvasive alternative therapy since it is considered safe when compared to the potential risks of topical steroid therapy or surgical exposure.
Collapse
Affiliation(s)
- Mohammad S Bin Dlaim
- Pediatric Ophthalmology Division, King Abdullah bin Abdulaziz University Hospital, Riyadh, SAU
| | - Ghadah A Alhussein
- College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, SAU
| | - Raneem S Alqahtani
- College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, SAU
| | - Leenah T Almanea
- College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, SAU
| |
Collapse
|
4
|
Bessonnat A, Benoit‐Biancamano M, Vanore M. Recurrence of conjunctival exuberant granulation tissue in a pony. EQUINE VET EDUC 2023. [DOI: 10.1111/eve.13769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Amandine Bessonnat
- Department of Clinical Sciences, Faculty of Veterinary Medicine Université de Montréal Saint‐Hyacinthe Quebec Canada
| | - Marie‐Odile Benoit‐Biancamano
- Groupe de recherche en pharmacologie animale du Québec (GREPAQ), Department of Pathology and Microbiology, Faculty of Veterinary Medicine Université de Montréal Saint‐Hyacinthe Quebec Canada
| | - Maria Vanore
- Department of Clinical Sciences, Faculty of Veterinary Medicine Université de Montréal Saint‐Hyacinthe Quebec Canada
| |
Collapse
|
5
|
Dreesbach M, Reinhard T, Maier P. [Granulomatous scleritis?]. DIE OPHTHALMOLOGIE 2022; 119:966-969. [PMID: 34981172 DOI: 10.1007/s00347-021-01558-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/05/2021] [Accepted: 12/05/2021] [Indexed: 01/26/2023]
Affiliation(s)
- Michelle Dreesbach
- Klinik für Augenheilkunde, Universitätsklinik Freiburg, Kilianstr. 5, 79106, Freiburg im Breisgau, Deutschland.
| | - Thomas Reinhard
- Klinik für Augenheilkunde, Universitätsklinik Freiburg, Kilianstr. 5, 79106, Freiburg im Breisgau, Deutschland
| | - Philip Maier
- Klinik für Augenheilkunde, Universitätsklinik Freiburg, Kilianstr. 5, 79106, Freiburg im Breisgau, Deutschland
| |
Collapse
|
6
|
Jaiswal H, Patidar N, Shah C, Singh R, Jain E, Piyush P. Topical timolol 0.5% as the primary treatment of ophthalmic pyogenic granuloma: A prospective, single-arm study. Indian J Ophthalmol 2021; 69:1155-1160. [PMID: 33913850 PMCID: PMC8186631 DOI: 10.4103/ijo.ijo_2404_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Purpose: To study topical timolol (0.5%) as a first-line treatment in ophthalmic pyogenic granuloma (PG) in terms of safety and efficacy. Methods: This was a prospective, interventional, single-arm study conducted at a tertiary eye care hospital in central India. Only new cases of PG were counseled to get enrolled in the study. A total of 40 patients were analyzed in the study. Topical timolol eye drop (0.5%) was started in each patient twice daily for 4–6 weeks duration. The patients were divided into five categories according to the percentage reduction in the size of PG as follows: i) 80–100% reduction - excellent responders, ii) 60–80% – good, iii) 40–60% – satisfactory, iv) 20–40% – poor, and v) <20% – very poor/nonresponder. After 6 months of starting treatment final evaluation was done. Results: The mean age of the patients was 23.5 ± 13.3 years. Etiology of the disease included chalazion (n = 11, 27.5%), trauma (n = 2, 5%), surgery (n = 7, 17.5%), foreign body (n = 2, 5%), and idiopathic (n = 18, 45%). An excellent response was achieved in 31 (77.5%) patients. Twenty-seven (67.5%) patients had complete resolution of lesions within 6 weeks. Recurrence of the lesion was not noticed in any patients. Conclusion: Timolol 0.5% in topical form is a good treatment option for ophthalmic PG in all age groups. The treatment has no adverse effects when given to suitable individuals for a limited period.
Collapse
Affiliation(s)
- Hrishabh Jaiswal
- Department of Orbit and Oculoplasty, Sadguru Netra Chikitsalya and Postgraduate Institute of Ophthalmology, Jankikund, Chitrakoot, Madhya Pradesh, India
| | - Narendra Patidar
- Department of Orbit and Oculoplasty, Sadguru Netra Chikitsalya and Postgraduate Institute of Ophthalmology, Jankikund, Chitrakoot, Madhya Pradesh, India
| | - Chintan Shah
- Department of Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalya and Postgraduate Institute of Ophthalmology, Jankikund, Chitrakoot, Madhya Pradesh, India
| | - Rukmendra Singh
- Department of Orbit and Oculoplasty, Sadguru Netra Chikitsalya and Postgraduate Institute of Ophthalmology, Jankikund, Chitrakoot, Madhya Pradesh, India
| | - Elesh Jain
- Consultant and Administrator, Sadguru Netra Chikitsalya and Postgraduate Institute of Ophthalmology, Jankikund, Chitrakoot, Madhya Pradesh, India
| | - Parimal Piyush
- Department of Orbit and Oculoplasty, Sadguru Netra Chikitsalya and Postgraduate Institute of Ophthalmology, Jankikund, Chitrakoot, Madhya Pradesh, India
| |
Collapse
|
7
|
Lee SH, Kim KW, Chun YS. Conjunctival Pyogenic Granuloma after Sub-tenon’s Block. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2021. [DOI: 10.3341/jkos.2021.62.4.566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
8
|
Adult Primary Capillary Hemangioma of the Sclera: A Previously Undescribed Entity With a Review of Epibulbar Vascular Lesions. Ophthalmic Plast Reconstr Surg 2021; 36:327-333. [PMID: 31895731 DOI: 10.1097/iop.0000000000001582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The objective of this article is to document a unique case of a primary hemangioma and review epibulbar vascular tumors of the conjunctiva and episclera. METHODS A case report with detailed histopathologic, histochemical, and immunohistochemical studies coupled with a comprehensive review of the relevant literature with a tabulation of previously reported epibulbar vascular lesions was performed. RESULTS A vascular tumor developed in a 46-year-old woman over 2-3 months that histopathologically was located in the superficial third of the normally avascular sclera and was composed of capillary caliber vessels. CD31 and CD34 positivity established the vascular nature of the lesion. Despite its adult onset, the tumor was also glut-1 positive, a vascular characteristic of childhood capillary hemangiomas that will ultimately involute. Smooth muscle actin was positive in the endothelial cells and associated pericytes. An ectatic muscular vessel identified in the midst of the lesion was interpreted as an anomalous intrascleral branch of an epibulbar anterior ciliary artery, where it perforated the sclera in the vicinity of the insertion of an extraocular rectus muscle. It was deduced to be the source of the capillary proliferation. A literature review failed to identify any previously reported epibulbar vascular tumor that originated primarily in the sclera or secondarily infiltrated this ocular tunic. CONCLUSION An adult primary capillary intrascleral neoplasm is described as the rarest of all epibulbar vascular tumors and in keeping with the exceptional status of the ocular endothelium was glut-1 positive. This lesion must be distinguished from an array of other common and esoteric epibulbar vascular conditions.
Collapse
|
9
|
Lee SH, Bae SH, Kim KW. Lamellar Graft of an Acellular, Preserved Human Cornea for Recurrent Anterior Granuloma in Stevens-Johnson Syndrome. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2020. [DOI: 10.3341/jkos.2020.61.11.1358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
10
|
Nair AG, George RJ, Natarajan S, Jain V. Topical timolol for the treatment of conjunctival pyogenic granulomas: Outcomes and effect on intraocular pressure. Indian J Ophthalmol 2020; 68:2170-2174. [PMID: 32971633 PMCID: PMC7728039 DOI: 10.4103/ijo.ijo_183_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose: To report the clinical outcomes of 0.5% timolol maleate eye drops for the treatment of conjunctival pyogenic granuloma (PG) and its effect on intraocular pressure (IOP). Methods: In this retrospective study, consecutive patients with conjunctival pyogenic granuloma between January 2019 and September 2019 were prescribed 0.5% timolol maleate eye drops twice a day and followed up for 8 weeks. IOPs were measured before treatment, while on treatment and 6 weeks after treatment. Results: A total of 12 patients with conjunctival PGs were treated with 0.5% timolol maleate eye drops. Patients ranged from 7 to 72 years with a mean age of 31.1 years. Eleven (11/12; 91.6%) patients had complete resolution of pyogenic granulomas after a mean duration of treatment of 4.4 weeks (range: 3–6 weeks). One patient had a persistent PG, which showed sub-optimal resolution at 6 weeks of treatment and was surgically excised. The mean IOP of the affected eye at presentation was 15.1 mm Hg (range: 10 to 20 mm Hg; SD: ±2.9 mm Hg). One week after initiating therapy, the mean IOP was 12.1 mm Hg (range: 8–16 mm Hg; SD: ±2.4 mm Hg). The mean reduction IOP compared to the baseline IOP was statistically significant (p = 0.02). No adverse events were noted in any of the patients. Conclusion: Topical timolol is effective in the treatment of conjunctival pyogenic granulomas with no major side effects. There is a significant reduction in IOP while on treatment which is reversible and returns to baseline following completion of therapy.
Collapse
Affiliation(s)
- Akshay Gopinathan Nair
- Aditya Jyot Eye Hospital, Mumbai; Advanced Eye Hospital and Institute, Navi Mumbai, Maharashtra, India
| | - Ronnie Jacob George
- Smt Jadhavabai Nathmal Singhvee Glaucoma Services, Sankara Nethralaya, Medical Research Foundation, Chennai, Tamil Nadu, India
| | | | - Vandana Jain
- Advanced Eye Hospital and Institute, Navi Mumbai, Maharashtra, India
| |
Collapse
|
11
|
Dagi LR, Velez FG, Archer SM, Atalay HT, Campolattaro BN, Holmes JM, Kerr NC, Kushner BJ, Mackinnon SE, Paysse EA, Pihlblad MS, Pineles SL, Strominger MB, Stager DR, Stager D, Capo H. Adult Strabismus Preferred Practice Pattern®. Ophthalmology 2020; 127:P182-P298. [DOI: 10.1016/j.ophtha.2019.09.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 09/20/2019] [Indexed: 11/25/2022] Open
|
12
|
Lee Y, Hyon JY, Jeon HS. Conjunctival Pyogenic Granuloma: Cases with Undetermined Etiologies. KOREAN JOURNAL OF OPHTHALMOLOGY 2019; 33:483-484. [PMID: 31612662 PMCID: PMC6791942 DOI: 10.3341/kjo.2019.0017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Yunjin Lee
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Joon Young Hyon
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Hyun Sun Jeon
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
| |
Collapse
|
13
|
Ophthalmic Pyogenic Granulomas Treated With Topical Timolol—Clinical Features of 17 Cases. Ophthalmic Plast Reconstr Surg 2018; 34:579-582. [DOI: 10.1097/iop.0000000000001116] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
14
|
Epithelial dysplasia in pterygium postoperative granuloma. Exp Eye Res 2018; 175:199-206. [PMID: 30125539 DOI: 10.1016/j.exer.2018.08.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 08/10/2018] [Accepted: 08/15/2018] [Indexed: 01/05/2023]
Abstract
Pterygium postoperative granuloma (PPG) is one of the common complications of pterygium surgery. In order to provide the structural features of PPG, and to further explore its pathogenetic mechanism, we analyzed clinical and pathological characteristics of 12 PPG cases. New blood vessels were observed under a slit lamp in PPG and peripheral conjunctival tissues. In vivo confocal imaging showed that there was extensive neovascularization in the stroma, accompanied by infiltration of dendritic cells and inflammatory cells. Dense fibrous structures were observed in some PPG tissues. H&E staining results confirmed neovascularization and inflammatory cells in PPG tissues. In addition, H&E staining exhibited epithelioid tissue covering some PPG tissues. The immunofluorescence results demonstrated that the PPG epithelium was negative for K19, K10 and Muc5AC. Compared with the normal conjunctiva and pterygium, the expression of collagen IV in PPG basement membrane decreased, the expression of pan-cytokeratin (PCK), claudin 4 and E-cadherin in PPG epithelium was significantly lower, while the expression of vimentin, α-SMA and Snail was significantly increased. Therefore, our results suggest that the expression of epithelial keratin markers and goblet cell specific mucin marker is downregulated in the PPG tissues, and it likely is associated with the occurrence of EMT in granulomatous tissues.
Collapse
|
15
|
Clinicopathologic Characteristics and the Surgical Outcome of Conjunctival Granulomas After Pterygium Surgery. Cornea 2018; 37:1008-1012. [DOI: 10.1097/ico.0000000000001647] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
16
|
Wu D, Qian T, Nakao T, Xu J, Liu Z, Sun X, Chu Y, Hong J. Medically uncontrolled conjunctival pyogenic granulomas: correlation between clinical characteristics and histological findings. Oncotarget 2018; 8:2020-2024. [PMID: 28008138 PMCID: PMC5356774 DOI: 10.18632/oncotarget.13961] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Accepted: 12/07/2016] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Conjunctival pyogenic granulomas are commonly seen after ocular surgeries or at an ocular wound site. The aim of this study is to describe a novel histological classification for medically uncontrolled conjunctival pyogenic granulomas (MUCPG), and to explore whether the diversity in clinical features correlates to different histological subtypes of MUCPG. METHODS This is an observational cross-section case series. We reviewed 46 consecutive patients with conjunctival pyogenic granulomas who did not respond to topical corticosteroids and underwent surgical excision from January 1, 2006 through December 31, 2015. Clinical features and histological findings were presented and analyzed. RESULTS Ocular surgery, accidental injury, and chalazion were the main predisposing causes of MUCPG. The lesions tended to occur unilaterally on the bulbar conjunctiva. Forty patients (87%) presented an enrichment of inflammatory cells and proliferated capillaries in their pathological sections (inflammatory pattern). Six patients (13%) showed relatively few inflammatory cells and capillaries within fibrous stroma (fibrous pattern). Patients with the inflammatory pattern were older (p = 0.025) and tended to be located in bulbar conjunctiva (p = 0.002). The predisposing causes were also different between two histological subtypes (p = 0.007). CONCLUSIONS We found the correlation between clinical presentation and histological subtypes in patients with MUCPG, indicating this disease may need a new classification scheme.
Collapse
Affiliation(s)
- Dan Wu
- Department of Ophthalmology and Visual Science and Eye Research Institute, Eye, and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Tingting Qian
- Department of Immunology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Takeshi Nakao
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
| | - Jianjiang Xu
- Department of Ophthalmology and Visual Science and Eye Research Institute, Eye, and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Zuguo Liu
- Eye Institute of Xiamen University Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian, China.,Eye Center and Department of Ophthalmology, The Second Xiangya Hospital and Eye Hospital, Central South University, Hunan, China
| | - Xinghuai Sun
- Department of Ophthalmology and Visual Science and Eye Research Institute, Eye, and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China.,Key Laboratory of Myopia, National Health and Family Planning Commission, Shanghai, China
| | - Yiwei Chu
- Department of Immunology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jiaxu Hong
- Department of Ophthalmology and Visual Science and Eye Research Institute, Eye, and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China.,Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA.,Eye Institute of Xiamen University Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian, China
| |
Collapse
|
17
|
Marback EF, Espinheira Fonseca L, Marback RL. Optic Disc Pyogenic Granuloma. Ocul Oncol Pathol 2017; 3:110-112. [PMID: 28868280 DOI: 10.1159/000451058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 09/16/2016] [Indexed: 11/19/2022] Open
Abstract
AIM The aim of this paper was to report a rare presentation of adenoid cystic carcinoma. METHOD This is a case report presenting clinical, radiographic, and histopathologic findings. RESULTS A 72-year-old female with no reported ocular symptoms was found to have an incidental right orbital mass on imaging. Additional studies revealed multiple liver lesions, which were biopsied and found to be consistent with adenoid cystic carcinoma. She was then referred to the ophthalmology service, where ocular examination demonstrated 2.5 mm of right proptosis with elevation and abduction deficits. Diplopia could be elicited in extreme upgaze and right lateral gaze. An excisional biopsy of the orbital mass was performed, with histopathology confirming the diagnosis of primary adenoid cystic carcinoma of the lacrimal gland, thereby also supporting the initial suspicion that the hepatic adenoid cystic carcinoma lesions represented metastases. CONCLUSION The authors describe a rare presentation of adenoid cystic carcinoma of the lacrimal gland, initially asymptomatic, with metastatic lesions restricted to the liver at the time of diagnosis. Three previous cases of adenoid cystic carcinoma with isolated metastatic hepatic lesions at the time of diagnosis have been reported; all of these cases localized the primary tumor to the salivary glands.
Collapse
|
18
|
Abstract
PURPOSE To perform a systematic review of the complications of strabismus surgery, focusing on incidence and risk factors. MATERIAL AND METHODS A systematic literature search was performed using the Medline and Cochrane databases. RESULTS Local complications, such as conjunctival injection and mild scarring, are almost universal but only rarely have long-term clinical significance. There are several important complications that are uncommon but associated with significant long-term sequelae, including slipped muscles, lost muscles, stretched scars, incarcerated muscles, pulled-in-two syndrome, periocular infections, orbital cellulitis, scleral perforations, retinal detachments, endophthalmitis, anterior segment ischemia, and surgical errors. DISCUSSION Strabismus surgery is associated with a number of common and serious complications, and it is important for both surgeons and patients to be aware of the risks.
Collapse
Affiliation(s)
- Michael J Wan
- Department of Ophthalmology, Boston Children's Hospital and Harvard Medical School , Boston, Massachusetts , USA
| | | |
Collapse
|
19
|
Vascular Tumors of the Conjunctiva in 140 Cases. Ophthalmology 2011; 118:1747-53. [DOI: 10.1016/j.ophtha.2011.04.034] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2010] [Revised: 04/26/2011] [Accepted: 04/27/2011] [Indexed: 11/18/2022] Open
|
20
|
Abstract
Purpose: This study was aimed at to determine the frequency of excised conjunctival lesions in a patient population treated over a 10-year period. Materials and Methods: The data of all excised conjunctival lesions with tissue diagnoses from 1998 to 2008 in the pathology department were analyzed. Results: The patient group comprised 192 conjunctival specimens; 106 (55.2%) obtained from male patients and 86 (44.8 %) from female patients. The age range was 75 years with a mean age of 27.07 ± 17 years. The most frequent excised lesions were pyogenic granulomas, which represented 30.7% (59 cases). Pigmented epithelial tumors were the second most common benign conjunctival lesions (44 cases, 22.9%). Out of these cases, compound nevus represented 86.4% (38 cases) and junctional nevus represented 6.8% (3 cases). Primary acquired melanosis and subepithelial nevus were reported in two cases (4.5%) and one case (2.3%), respectively. Cystic lesions represented 12% (23 cases). These were mostly ductal retention cysts in 16 cases (70%), occupying the fornix in eight cases. Ocular surface squamous neoplasia (OSSN) was detected in 21 cases (10.9%) significantly affecting an older age group as compared to other lesions (mean age 45.9 ± 16.7). Other less frequent lesions included papilloma (10 cases, 2.5%), dermolipoma (8 cases, 4.2%), solid dermoid (3 cases, 1.6%), hemangioma (15 cases, 7.8%), and benign reactive lymphoid hyperplasia (four cases, 2.1%). Conclusion: Benign lesions were the most frequent histologically diagnosed conjunctival lesions. The true malignant lesions were lower than what has been described in many reports. The significant proportion of precancerous OSSN can be attributed to sun exposure and ultraviolet light in Egypt.
Collapse
|
21
|
Wauters O, Sabatiello M, Nikkels-Tassoudji N, Choffray A, Richert B, Piérard GE, Nikkels A. Le botryomycome. Ann Dermatol Venereol 2010; 137:238-42, quiz 237, 243. [DOI: 10.1016/j.annder.2009.12.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2009] [Accepted: 09/23/2009] [Indexed: 12/11/2022]
|
22
|
Affiliation(s)
- David K Coats
- Texas Children’s Hospital, 6701 Fannin Street, Clinical Care Center, Houston, TX 77030, USA
| |
Collapse
|