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1.
Int Ophthalmol ; 44(1): 251, 2024 Jun 22.
Artículo en Inglés | MEDLINE | ID: mdl-38907750

RESUMEN

OBJECTIVE: To study the efficacy and side-effect profile of topical 5-Fluorouracil (5-FU) in the treatment of ocular surface squamous neoplasia (OSSN). METHODS: Retrospective study of 101 eyes of 100 patients treated with 5-FU with one week on and 3 weeks off regimen. RESULTS: Of the 100 patients (101 eyes), the mean age at diagnosis of OSSN was 49 (median, 52 years; range, 11-87 years). History of prior intervention was noted in 6 (6%) eyes. Tumor epicenter included bulbar conjunctiva (n = 54; 53%), limbus (n = 27; 27%), and cornea (n = 20;20%). Mean number of cycles of topical 5-FU administered was 3 (median, 3; range, 1-8). Complete tumor regression was achieved with topical 5-FU in 89 (88%) eyes with a mean number of 2 cycles (median, 2; range, 1-6) of 5-FU. The remaining 12 (12%) lesions underwent additional treatment including excisional biopsy (n = 7), extended enucleation (n = 3), and topical Interferon alpha 2b (n = 2) for complete tumor control. Over a mean follow-up period of 6 months (median, 5 months; range, 1-36 months) following treatment, tumor recurrence was noted in 2 (2%) patients, and side-effects were noted in 7 (7%) eyes including conjunctival hyperemia (n = 1), punctal stenosis (n = 1), sterile keratitis (n = 4), and limbal stem cell deficiency (n = 1). CONCLUSION: Topical 5-FU is an effective non-invasive therapy for OSSN with a minimal side-effect profile.


Asunto(s)
Antimetabolitos Antineoplásicos , Carcinoma de Células Escamosas , Fluorouracilo , Soluciones Oftálmicas , Humanos , Fluorouracilo/administración & dosificación , Estudios Retrospectivos , Anciano , Masculino , Persona de Mediana Edad , Femenino , Adulto , Anciano de 80 o más Años , Adolescente , Antimetabolitos Antineoplásicos/administración & dosificación , Adulto Joven , Soluciones Oftálmicas/administración & dosificación , Niño , Resultado del Tratamiento , Carcinoma de Células Escamosas/tratamiento farmacológico , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/diagnóstico , Administración Tópica , Neoplasias del Ojo/tratamiento farmacológico , Neoplasias del Ojo/diagnóstico , Neoplasias de la Conjuntiva/tratamiento farmacológico , Neoplasias de la Conjuntiva/diagnóstico , Neoplasias de la Conjuntiva/patología , Enfermedades de la Córnea/tratamiento farmacológico , Enfermedades de la Córnea/diagnóstico , Estudios de Seguimiento
3.
J Clin Exp Hematop ; 64(2): 86-96, 2024 Jun 27.
Artículo en Inglés | MEDLINE | ID: mdl-38684405

RESUMEN

To elucidate long-term outcome in primary conjunctival lymphoma, a review was conducted of 31 consecutive patients: 21 men and 10 women with an age range of 28 to 85 (median, 61) years at presentation and follow-up periods ranging from 1 to 19 (median, 7) years. Conjunctival lymphoma was on the right side in 10 patients, on the left side in 12, and on both sides in 9. Upper, lower, or both fornix lesions in 28 patients were all diagnosed as extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma), while thick nasal bulbar conjunctival lesions in 3 patients were differently diagnosed as MALT lymphoma, diffuse large B-cell lymphoma, and follicular lymphoma, respectively. Seven patients underwent local radiation (30 Gy): as initial treatment in 5 patients and treatment for relapse in 2 patients. The remaining 24 patients were observed without additional treatment after excisional biopsy: 5 of these 24 patients showed relapse 0.5 to 6 years later and underwent excisional biopsy again that revealed MALT lymphoma. Of the 5 patients with relapse, only one with second-time relapse underwent radiation. Fluorodeoxyglucose positron emission tomography was performed in 18 patients and showed no systemic lesions: high uptake was noted in the residual conjunctival lesions of 4 patients and in the relapsed conjunctival lesions of 3 patients. One patient died of rectal cancer while no patients died of lymphoma. Observation is an option in patients with primary conjunctival lymphoma after excisional biopsy. Radiation is a treatment option in the case of relapse.


Asunto(s)
Neoplasias de la Conjuntiva , Linfoma de Células B de la Zona Marginal , Humanos , Masculino , Femenino , Persona de Mediana Edad , Neoplasias de la Conjuntiva/patología , Neoplasias de la Conjuntiva/terapia , Neoplasias de la Conjuntiva/diagnóstico , Anciano , Adulto , Anciano de 80 o más Años , Linfoma de Células B de la Zona Marginal/patología , Linfoma de Células B de la Zona Marginal/diagnóstico , Linfoma de Células B de la Zona Marginal/mortalidad , Linfoma de Células B de la Zona Marginal/terapia , Linfoma de Células B de la Zona Marginal/radioterapia , Biopsia , Recurrencia Local de Neoplasia/patología , Estudios de Seguimiento , Recurrencia
4.
Cornea ; 43(8): 1062-1064, 2024 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-38635480

RESUMEN

PURPOSE: The diagnosis of conjunctival squamous intraepithelial neoplasia (CSIN) can be difficult because of the heterogeneous appearance. Despite established risk factors and diagnostic support by high-resolution optical coherence tomography (hrOCT) and indocyanine green angiography (ICGA), the only reliable diagnostic method is a histological work-up. This case report is the first to describe corneal microaneurysms in CSIN as a vascular feature for conjunctival tumor angiogenesis. METHODS: An 84-year-old male patient was referred with a suspected diagnosis of pterygium. Biomicroscopic examination revealed a whitish epithelial lesion of conjunctival origin with centripetal corneal growth and extension over 5 limbal hours. Intralesional vascularization showed highly altered morphology with aneurysmal changes. After imaging with hrOCT and ICGA, excision was performed in a "no-touch double-freeze and thaw" technique, followed by histological and immunohistochemical work-up. RESULTS: hrOCT showed an epithelial, hyperreflective lesion with a maximum thickness of 272 µm and sharp central border. ICGA confirmed active perfusion and partial thrombosis of the aneurysmal terminal vascular buds dilated to 405 µm with early dye leakage within the first minute. Histological examination confirmed the clinical diagnosis of CSIN with focal high-grade dysplasia. Postoperatively, there was no recurrence during the observation period of 5 months. CONCLUSIONS: Intralesional terminal microaneurysms are a feature of tumor angiogenesis in CSIN. The relevance and frequency of this potential new risk factor for malignancy should be investigated in further studies.


Asunto(s)
Carcinoma in Situ , Neoplasias de la Conjuntiva , Microaneurisma , Tomografía de Coherencia Óptica , Humanos , Masculino , Anciano de 80 o más Años , Neoplasias de la Conjuntiva/diagnóstico , Tomografía de Coherencia Óptica/métodos , Carcinoma in Situ/diagnóstico , Carcinoma in Situ/patología , Microaneurisma/diagnóstico , Enfermedades de la Córnea/diagnóstico , Enfermedades de la Córnea/cirugía , Enfermedades de la Córnea/etiología , Angiografía con Fluoresceína/métodos , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patología , Colorantes/administración & dosificación , Verde de Indocianina/administración & dosificación
5.
Klin Monbl Augenheilkd ; 241(4): 402-405, 2024 Apr.
Artículo en Alemán | MEDLINE | ID: mdl-38653294

RESUMEN

BACKGROUND/OBJECTIVES: Ocular surface squamous neoplasia (OSSN) are among the most frequent non-pigmented malignancies of the ocular surface. They have a wide range of histological characteristics - ranging from mild epithelial dysplasia to invasive carcinoma of the squamous cells of the cornea. They may be restricted to the conjunctiva or also involve the cornea. As there are no leading symptoms in the early stages, diagnosis may be very delayed in patients who do not receive regular ophthalmological treatment. The present case series describes clinical and histological data on OSSN and includes clinical and histological data on OSSN, including possible clinical presentations, important risk factors, special histological and cytological features and therapeutic options. METHODS: Retrospective case series of patients with histologically confirmed severe epithelial dysplasia of the conjunctiva and cornea consistent with OSSN who presented to the Department of Ophthalmology in Basel University Hospital. The analysis covered demographic data, symptoms, diagnostic testing (photo documentation, brush biopsy), treatment and cytological and/or histological material and findings. RESULTS: We report on five patients aged between 41 and 92 years at the time of diagnosis. The histological findings in all patients included severe epithelial dysplasia, but with a heterogenous clinical presentation. In all cases, the lesion started in the conjunctiva, but traversed the limbus and extended to the cornea. The primary treatment was always surgical removal. In one patient, this had to be repeated several times due to recurrent metaplasia and was complemented by subsequent mitomycin C therapy. The clinical outcome ranged between total restitution of the original state to inevitable enucleation. CONCLUSION: The clinical presentation of OSSN is highly heterogenous, so that the initial diagnosis is difficult. There are no official guidelines for treatment, so that the treatment of choice varied between clinics. Regular ophthalmological follow-ups are recommended, even after complete surgical excision. Possible relevant concomitant diseases and risk factors must be identified before therapy.


Asunto(s)
Neoplasias de la Conjuntiva , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/terapia , Carcinoma de Células Escamosas/cirugía , Neoplasias de la Conjuntiva/diagnóstico , Neoplasias de la Conjuntiva/patología , Neoplasias de la Conjuntiva/terapia , Enfermedades de la Córnea/diagnóstico , Enfermedades de la Córnea/patología , Enfermedades de la Córnea/terapia , Epitelio Corneal/patología , Neoplasias del Ojo/diagnóstico , Neoplasias del Ojo/terapia , Neoplasias del Ojo/patología , Neoplasias del Ojo/cirugía , Estudios Retrospectivos , Resultado del Tratamiento
6.
Ophthalmologie ; 121(5): 391-396, 2024 May.
Artículo en Alemán | MEDLINE | ID: mdl-38446196

RESUMEN

BACKGROUND: Neoplasms of the conjunctiva include many different entities with a broad variety of clinical presentations. This can make a precise clinical diagnosis difficult. R0 resection is the gold standard treatment for most malignant conjunctival neoplasms, but not every benign lesions must treated by excision. In clinical practice it is important to make an accurate clinical diagnosis to enable the best possible management of conjunctival neoplasms. OBJECTIVE: The aim of this study was to determine the accuracy of clinical diagnosis of neoplasms of the conjunctiva. MATERIALS AND METHODS: Within a retrospective design, the data from all patients with excision of a conjunctival lesion between 2011 and 2020 in the Department of Ophthalmology of the UKSH Campus Kiel were extracted and analyzed. The specificity, sensitivity, and positive and negative predictive value for the preoperative clinical rating of dignity and diagnosis were evaluated based on the histological diagnostic findings. RESULTS: Of 220 included cases, 75% were benign and 25% malignant. The most frequent neoplasm of the conjunctiva was benign conjunctival nevus. The sensitivity for clinical prediction of a benign lesion was 0.86 (95% confidence interval [CI] 0.59-0.92), the specificity 0.95 (CI 0.85-0.99), and the positive predictive value 0.98 (CI 0.94-1.0). The sensitivity for clinical prediction of malign dignity was 0.95 (CI 0.85-0.99), the specificity 0.88 (CI 0.83-0.93), and the positive predictive value 0.73 (CI 0.61-0.83). CONCLUSION: The derived values for clinical diagnosis of conjunctival neoplasms can be rated as good. However, in clinical practice, untypical lesions can be hard to diagnose correctly, and the clinical diagnosis should be carefully reviewed; if in doubt, excision should be preferred.


Asunto(s)
Neoplasias de la Conjuntiva , Sensibilidad y Especificidad , Humanos , Neoplasias de la Conjuntiva/patología , Neoplasias de la Conjuntiva/cirugía , Neoplasias de la Conjuntiva/diagnóstico , Estudios Retrospectivos , Femenino , Masculino , Persona de Mediana Edad , Anciano , Adulto , Adulto Joven , Adolescente , Anciano de 80 o más Años , Conjuntiva/patología , Conjuntiva/cirugía , Niño , Valor Predictivo de las Pruebas
8.
Rom J Morphol Embryol ; 65(1): 35-44, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38527982

RESUMEN

Ocular melanoma is a rare but complex disease in current medical practice. Our retrospective study spans over a period of 28 years and analyzed uveal and conjunctival melanomas that were consecutively admitted, diagnosed, and treated in the 2nd Ophthalmology Clinic of Prof. Dr. Nicolae Oblu Emergency Clinical Hospital, Iasi, Romania. The patients were selected from the records of the Department of Pathology of our Hospital, being diagnosed by standard histopathological techniques. The aim of this study was to summarize the epidemiological and pathological aspects of uveal and conjunctival melanomas in Northeastern region of Romania. In our study, we did not notice a predilection of uveal and conjunctival melanoma to one particular gender. The most common histological subtypes of ocular melanomas were the heavily pigmented spindle cell subtype, followed by the epithelioid subtype. Our patients sought medical help in a timely manner, before the systemic invasion of the disease could develop.


Asunto(s)
Neoplasias de la Conjuntiva , Neoplasias del Ojo , Melanoma , Neoplasias de la Úvea , Humanos , Melanoma/epidemiología , Melanoma/patología , Rumanía/epidemiología , Estudios Retrospectivos , Neoplasias del Ojo/epidemiología , Neoplasias de la Conjuntiva/diagnóstico , Neoplasias de la Úvea/epidemiología , Neoplasias de la Úvea/patología
9.
Medicine (Baltimore) ; 103(10): e37342, 2024 Mar 08.
Artículo en Inglés | MEDLINE | ID: mdl-38457580

RESUMEN

RATIONALE: Conjunctival myxoma is a rare benign tumor, which can mimic more common conjunctival lesions such as a cyst, lymphangioma, amelanotic nevus, neurofibroma, amelanotic melanoma, or lipoma. We describe a patient with the conjunctival myxoma, who was initially misdiagnosed as a conjunctival cyst. This case report includes intraoperative photographs and various immunohistochemical staining images. PATIENTS CONCERNS: A 55-year-old woman presented with a painless mass in the superotemporal conjunctiva of the left eye, which she had noticed 1 month ago. The patient had no previous history of trauma or eye surgery. Slit-lamp examination revealed a well-circumscribed, freely movable, pinkish, semi-translucent mass on the temporal bulbar conjunctiva, suggestive of a conjunctival cyst. DIAGNOSES: Histopathological analysis showed stellate- and spindle-shaped cells within the loose myxoid stroma, confirming a diagnosis of conjunctival myxoma. INTERVENTIONS: The conjunctival lesion was completely excised under local anesthesia. OUTCOMES: After 4 months of follow-up, the patient remained in good health without recurrence of the conjunctival lesion and no evidence of any systemic abnormality. LESSONS: Myxoma is an extremely uncommon benign tumor derived from primitive mesenchyme. Considering the rarity of the tumor and its similarity to other conjunctival tumors, diagnosis can be challenging. Ophthalmologists should consider myxoma as a possible differential diagnosis when encountering conjunctival lesions. Surgical excision is essential to confirm the diagnosis and careful systemic evaluation is required to prevent potentially life-threatening underlying systemic conditions.


Asunto(s)
Neoplasias de la Conjuntiva , Quistes , Mixoma , Neoplasias Cutáneas , Femenino , Humanos , Persona de Mediana Edad , Neoplasias de la Conjuntiva/diagnóstico , Neoplasias de la Conjuntiva/cirugía , Neoplasias de la Conjuntiva/patología , Mixoma/diagnóstico , Mixoma/cirugía , Mixoma/patología , Conjuntiva/patología
10.
Zhonghua Yan Ke Za Zhi ; 60(3): 278-280, 2024 Mar 11.
Artículo en Chino | MEDLINE | ID: mdl-38462378

RESUMEN

An 81-year-old female patient experienced a rapid increase in the volume of a rice-sized black mass on the left eye over a period of six months. The mass extended out of the eye and exhibited surface erosion with accompanying hemorrhage. Following a live tissue examination and histopathology after orbital exenteration under general anesthesia, the diagnosis of a giant malignant palpebral conjunctival melanoma of the spindle cell subtype was confirmed. The patient refused to undergo local radiation therapy or systemic chemotherapy and died from the disease six months later.


Asunto(s)
Neoplasias de la Conjuntiva , Melanoma , Femenino , Humanos , Anciano de 80 o más Años , Conjuntiva/patología , Neoplasias de la Conjuntiva/diagnóstico
11.
Acta Ophthalmol ; 102(5): e851-e861, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38420891

RESUMEN

PURPOSE: To identify high-risk histopathologic and molecular features of local recurrence, nodal metastasis, distant metastasis (DM) and disease-specific death (DSD) in conjunctival melanoma (CoM). METHODS: Ninety patients with pathologically diagnosed CoM between 2008 and 2023 were enrolled. Immunohistochemistry staining of BRAFV600E, NRASQ61R, CD117, PD-1 and PD-L1 was performed in 65 and 45 patients, respectively. Cox regression and Kaplan-Meier survival analysis were conducted to identify risk factors for local recurrence, nodal metastasis, DM and DSD. RESULTS: Pathologically, ulceration (hazard ratio [HR]: 3.170; 95% CI: 1.312-7.659; p = 0.01) and regression (HR: 3.196; 95% CI: 1.094-9.335; p = 0.034) were risk factors for DM. Tumour thickness ≥ 4 mm (HR: 4.889; 95% CI: 1.846-12.946; p = 0.001) and regression (HR: 4.011; 95% CI: 1.464-10.991; p = 0.007) were risk factors for DSD. For patients with tumour thickness < 4 mm, the presence of ulceration indicated a higher risk of nodal metastasis (log-rank p = 0.0011), DM (log-rank p = 0.00051) and DSD (log-rank p = 0.02). Patients with regression (+)/tumour-infiltrating lymphocytes (TILs) (+) had a higher risk for DM (log-rank p = 0.011) and DSD (log-rank p = 0.0032). Molecularly, the positive rate of BRAFV600E, NRASQ61R, CD117, PD-1 and PD-L1 was 40.00% (26/65), 43.08% (28/65), 70.77% (46/65), 46.67% (21/45) and 28.89% (13/45), respectively. Positive BRAFV600E was identified as an independent risk factor for DM (HR: 2.533; 95% CI: 1.046-6.136, p = 0.039). The expression level of BRAFV600E was positively correlated with vascular invasion (p = 0.01), as well as the expression levels of PD-1 (p = 0.038) and PD-L1 (p = 0.049). CONCLUSIONS: Tumour thickness ≥ 4 mm, ulceration, the coexistence of regression and TILs, and positive BRAFV600E were risk factors for poor prognosis of CoM patients. Besides, expression level of BRAFV600E was positively correlated with the expression levels of PD-1 and PD-L1.


Asunto(s)
Neoplasias de la Conjuntiva , Melanoma , Humanos , Melanoma/genética , Melanoma/diagnóstico , Melanoma/patología , Melanoma/metabolismo , Neoplasias de la Conjuntiva/genética , Neoplasias de la Conjuntiva/patología , Neoplasias de la Conjuntiva/metabolismo , Neoplasias de la Conjuntiva/diagnóstico , Masculino , Femenino , Persona de Mediana Edad , Anciano , Estudios Retrospectivos , Factores de Riesgo , Biomarcadores de Tumor/metabolismo , Biomarcadores de Tumor/genética , Adulto , Recurrencia Local de Neoplasia , Metástasis Linfática , Inmunohistoquímica , Proteínas Proto-Oncogénicas B-raf/genética , Anciano de 80 o más Años , Estudios de Seguimiento , Tasa de Supervivencia/tendencias , Estadificación de Neoplasias , Pronóstico
15.
Can J Ophthalmol ; 59(2): 79-82, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-36610703

RESUMEN

OBJECTIVE: Pterygium and ocular surface squamous neoplasia (OSSN) have been recognized as likely related conditions and share similar risk factors such as ultraviolet radiation and chronic inflammation. The purpose of this study is to review the incidence of OSSN in pathology specimens sent as pterygium at a single tertiary centre between 2010 and 2022. METHODS: This is a retrospective chart review of patients operated on for pterygium between 2010 and 2022 at the University of Montreal Health Centre. Data collected include baseline demographics, results of pathology specimen, and clinical information for cases diagnosed as OSSN on pathology. RESULTS: A total of 1559 patients were operated on for a clinical diagnosis of pterygium between 2010 and 2022, of which 854 patients (55%) were male. A total of 1142 specimens had available pathology reports, and most of the specimens were consistent with pterygium on pathology (1105 of 1142; 97%). There was an unexpected finding of 3 cases of OSSN (3 of 1142; 0.3%). Other diagnosis besides pterygium were seen in 3% of specimens (34 of 1142), including nevus (n = 12), spheroidal degeneration (n = 3), pyogenic granuloma (n = 3), and lymphangiectasia (n = 2). The 3 cases of OSSN included an 81-year-old male of French-Canadian background, a 52-year-old male of South Asian background, and a 59-year-old female of French-Canadian background. The pathology was diagnosed as conjunctival intraepithelial neoplasia (CIN) grade 3, CIN grade 2, and CIN grade 2, respectively. CONCLUSION: The finding of OSSN in pterygium is rare in our population but can be clinically difficult to distinguish. It is important to send all pterygium specimens for pathology.


Asunto(s)
Carcinoma de Células Escamosas , Conjuntiva/anomalías , Neoplasias de la Conjuntiva , Neoplasias del Ojo , Pterigion , Femenino , Humanos , Masculino , Persona de Mediana Edad , Anciano de 80 o más Años , Pterigion/diagnóstico , Pterigion/epidemiología , Estudios Retrospectivos , Incidencia , Rayos Ultravioleta , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/epidemiología , Carcinoma de Células Escamosas/patología , Canadá , Neoplasias de la Conjuntiva/diagnóstico , Neoplasias de la Conjuntiva/epidemiología , Neoplasias de la Conjuntiva/patología , Neoplasias del Ojo/cirugía
18.
Surv Ophthalmol ; 69(2): 230-240, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-37890676

RESUMEN

Indeterminate melanocytic proliferations of the conjunctiva have both benign and malignant features that previously made these lesions nearly impossible to categorize in existing classification schemes. With the evolution of immunohistochemistry and molecular genetics, however, subclassifications have emerged that allow for a more tailored diagnosis and management. These conjunctival melanocytic proliferations include deep penetrating nevus, granular cell nevus, and nevoid melanoma. There remains a small subset of conjunctival melanocytic proliferations that defy precise characterization as nevi, primary acquired melanosis, or melanomas despite currently available ancillary diagnostic modalities and remain indeterminate. We highlight these unusual types of nevi and melanomas, with an update on their morphologic, immunohistochemical, and molecular genetic characteristics.


Asunto(s)
Neoplasias de la Conjuntiva , Melanoma , Nevo , Neoplasias Cutáneas , Humanos , Melanoma/diagnóstico , Neoplasias de la Conjuntiva/diagnóstico , Neoplasias de la Conjuntiva/patología , Nevo/diagnóstico , Nevo/metabolismo , Nevo/patología , Neoplasias Cutáneas/patología , Conjuntiva/metabolismo , Conjuntiva/patología
19.
Eye (Lond) ; 38(6): 1118-1124, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-37996734

RESUMEN

AIMS: The aim of the study is to assess non-invasive diagnostic modalities for ocular surface squamous neoplasia (OSSN) when compared to histology. METHODS: A prospective case-control study was conducted of patients presenting with conjunctival masses at a tertiary eye hospital in Johannesburg, South Africa. Patients completed an interview and had three non-invasive diagnostic tests: optical coherence tomography, impression cytology and methylene blue stain. A biopsy with histology was performed as the gold standard to confirm the diagnosis. RESULTS: One hundred and eighty-two conjunctival masses of 175 patients were evaluated. There were 135 lesions identified as OSSN on biopsy and 47 lesions were benign on histology. Optical coherence tomography had a sensitivity and specificity of 87.2% (95% CI: 80.0-92.5) and 75.6% (95% CI: 60.5-87.1), respectively, when an epithelial thickness cutoff of 140 um was used. Shadowing was found in 46% of cases due to leukoplakia or increased thickness of the mass. Cytology had a sensitivity of 72.4% (95% CI: 62.5-81.0) and a specificity of 74.3% (95% CI: 56.7-87.5). Twenty-seven per cent of cytology specimens were excluded from analysis due to inadequate cellularity. Methylene blue had a high sensitivity of 91.9% (95% CI: 85.9-95.9), but low specificity of 55.3% (95% CI: 40.1-69.8). CONCLUSION: Optical coherence tomography had a high sensitivity and specificity as a non-invasive test and liquid-based cytology performed well but had a lower sensitivity and specificity than with optical coherence tomography. Methylene blue performed well as a screening test, with a high sensitivity but low specificity.


Asunto(s)
Carcinoma de Células Escamosas , Neoplasias de la Conjuntiva , Humanos , Centros de Atención Terciaria , Estudios de Casos y Controles , Sudáfrica , Azul de Metileno , Carcinoma de Células Escamosas/diagnóstico , Neoplasias de la Conjuntiva/diagnóstico , Neoplasias de la Conjuntiva/patología
20.
Cornea ; 43(3): 391-393, 2024 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-38147572

RESUMEN

PURPOSE: The aim of this study was to describe a rare case of conjunctival black henna accumulation that was clinically misdiagnosed as melanoma. METHODS: This retrospective case report reviewed the clinical findings and histopathologic features of a pigmented plica semilunaris lesion excised from a 63-year-old woman. The patient had a history of regular use of black henna in her childhood. The conjunctival pigmentation was present since her early teenage years but started to grow only recently. RESULTS: There was a darkly pigmented mass mainly covering the plica semilunaris of the right eye with additional irregularly scattered pigmentation in the medial bulbar conjunctiva. Excisional biopsy of the plical tumor revealed nodular pigment deposits with lymphocytic infiltration. There were no neoplastic cells. The specimen stained negative for pan-keratin, CD68, and CD34. Melanin bleaching was also negative. CONCLUSIONS: Long-term exposure to black henna as a hair dye may lead to subconjunctival accumulation and mimic melanoma.


Asunto(s)
Enfermedades de la Conjuntiva , Neoplasias de la Conjuntiva , Melanoma , Fenilendiaminas , Femenino , Humanos , Persona de Mediana Edad , Conjuntiva/patología , Enfermedades de la Conjuntiva/diagnóstico , Neoplasias de la Conjuntiva/diagnóstico , Neoplasias de la Conjuntiva/patología , Melanoma/diagnóstico , Melanoma/patología , Estudios Retrospectivos
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