Pathology Associates Of Lexington, P.A.
Pathology Associates Of Lexington, P.A.
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Pathology Associates Of Lexington, P.A.
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Our practice encounters relatively little ophthalmic surgical pathology. So, some cases are listed. In using Google, do a primary search on ocular pathology; then subsearch for the particular entity of interest stated in the clinical info section of the specimen requisition.
  • Surgical specimens
    1. corneal or conjunctival squamous papilloma [L08-11567].
    2. Salzmann's nodule of corneal peripery, nodular elastic tissue1 [L08-11143].
    3. Primary acquired melanosis of conjunctiva1 [L09-2006], with nearly MIS melanoma [L10-3538].
    4. Eyelid dermatochalasis (droopy & excess) may show the dermal stellate fibroblasts that appear when skin is excessively rubbed or manipulated [L09-2502].
    5. actinic lesions of bulbar conjunctiva: they have (a) actinic basophilic elastotic deposits and (b) chronic inflamatory cells and (c) increased stromal vascularity. Pterygium is a lesion approaching the cornea [L09-3524], while a pengueculum is centered betwwen the cornea and either the nasal or temporal limbus of the eye.
    6. granulomatous lesions = chalazion (tarsal plate to lid edge meibomian gland problem...lipogranulomatous [L14-1129]) or possibly a chronic complicated "stye" (hordeolum) infection of the lid margin eyelash sebaceous glands of Zeis [S09-6535] in sort of a lipogranulomatous reaction (S11-2598) where there are spaces left after sebum dissolved out.
    7. lacrimal glands may be biopsied for execution of the Greenspan score in search of diagnostic support for the diagnosis of Sjorgren's syndrome.
    8. occular pemphigoid: biopsy sent for DIF analysis.
  • Autopsy clues:
    1. yellow sclerae: jaundice...watch out for liver disease.
    2. pigmented (brown/black) sclerae: check costochondral areas and vertebrae grossly for the dark pigmentation of ochronosis.
    3. blue (thin) sclerae: think of osteogenesis imperfecta, ochronosis, Ehlers-Danlos syndrome, De Barsy syndrome, Loeys-Dietz syndrome, & Marshall-Smith syndrome.

References:

  1. Mission for Vision website (clinical photos, etc.)...use their internal search engine and/or click on "ocular pathology tutorial".
  2. Munoz J & Hanbali A, "JAMA CLINICAL CHALLENGE: Blue Sclearae", JAMA 307(12): 1310-11, 28 March 2012.
  3. (page started 11/8/08; latest addition 6 April 2014)

 
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