Cutaneous pleomorphic adenoma of the periocular region - a case series.

Mixed tumour of the skin is a rare entity also known as chondroid syringoma and pleomorphic adenoma. These usually present as slow-growing skin nodules with a smooth surface, clear boundaries, and no ulceration. Case series exist describing pleomorphic adenomas in the periocular region including the lids and orbit, separate to the more familiar lacrimal gland pleomorphic adenoma. These may arise from accessory or ectopic lacrimal gland tissue but in the eyelids are more likely to arise from sweat glands in the skin. Histopathological analysis of these lesions is important to identify complete excision, minimising recurrences and in identifying rare but potential malignant transformation. We describe the clinical features and outcomes in three cases of pleomorphic adenoma with two at the medial canthus (including one recurrence) and one in the brow region.

Donor preparation using pneumatic dissection in endothelial keratoplasty: DMEK or DSEK?

PURPOSE: To determine if residual stroma remains on the Descemet membrane when pneumatic dissection is used to prepare donor tissue for endothelial keratoplasty. METHODS: Pneumatic dissection using a posterior peripheral needle insertion was carried out on 5 eye bank corneas. Samples were then sent for histological analysis. RESULTS: A thin layer of stroma remained on the Descemet membrane in all the samples. The average central stromal thickness was 12.4 µm (range 6.5-20.0 µm). CONCLUSIONS: Endothelial keratoplasty using pneumatic dissection to prepare donor tissue should be considered a form of Descemet stripping endothelial keratoplasty and not Descemet membrane endothelial keratoplasty. If future studies show excellent visual results using pneumatic dissection for endothelial keratoplasty, then removal of all donor stroma may be unnecessary.

Residual corneal stroma in big-bubble deep anterior lamellar keratoplasty: a histological study in eye-bank corneas.

AIM: To determine if residual corneal stroma remains on the recipient posterior lamella in big-bubble deep anterior lamellar keratoplasty (DALK). METHODS: Pneumodissection using the big-bubble technique was carried out on eye-bank corneas mounted on an artificial anterior chamber. Samples that had a successful big-bubble formation were sent for histological evaluation to determine if any residual stroma remained on the Descemet membrane (DM). RESULTS: Big-bubble formation was achieved in 32 donor corneas. Two distinct types of big-bubble were seen: the bubble had either a white margin (30 corneas) or a clear margin (two corneas). The posterior lamellae of all the white margin corneas showed residual stroma on DM with a mean central thickness of 7.0 µm (range 2.6-17.4 µm). The clear margin corneas showed no residual stroma on DM. CONCLUSION: It should no longer be assumed that big-bubble DALK, where the bubble has a white margin, routinely bares DM. True baring of DM may only occur with the less commonly seen clear margin bubble.

Angiogenesis in non-small cell lung cancer: microvessel area in needle biopsy in vascular tumor density.

OBJECTIVE: To evaluate angiogenesis in non-small cell lung cancer (NSCLC) through immunohistochemistry with CD34 and computerized image analysis comparing the microvessel area in needle biopsies and surgical specimens. STUDY DESIGN: Core biopsies and surgical specimens from 28 patients with NSCLC were reviewed. Microvessels were highlighted by immunohistochemistry with anti-CD34. Tumor microvessel area was measured in digital photographs from hot spots of all samples. RESULTS: Average microvessel area among core samples was 5,093.6 microm2 (range, 233.4-17,916.8) and among surgical specimens was 3,599.3 microm2 (range, 376.9-9,514.0). There was strong correlation between overall microvascular area in biopsies and surgical specimens (r = 0.7; p = 0.0001). Mean area of core specimens was used to divide cases into groups of low and high vascular areas. A slightly stronger correlation was observed between biopsies and surgical specimens with low vascular areas (r = 0.84; p = 0.0001). CONCLUSION: There is strong correlation of microvessel area in core biopsies and respective surgical specimens in NSCLC. These data indicate that core specimens could be used to assess the extent of angiogenesis in NSCLC in the pretreatment phase.