Canaliculops Associated With Punctal Agenesis: A Clinicopathological Correlation and Review of Literature.

Canaliculops or canaliculocele is a rare form of noninflammatory and noninfectious canalicular ectasia. To the best of the authors' knowledge, so far only 5 such cases have been described in the literature. Typical clinical and characteristic immunohistochemical features aid in the diagnosis. Although rare, it should be kept in the differential diagnosis of cystic lesions in the medial canthus area. The authors report the sixth such case, but the first case to show an association with punctal agenesis. Addition of more such cases to literature will help unravel the etiopathogenesis of this intriguing canalicular disorder.

Extragnathic sino-orbital myxoma: an extremely rare tumor at an even rarer site.

Myxomas are rare benign tumors of primitive mesenchymal origin that usually arise from the soft tissues and occasionally from the bones. Bony myxomas predominantly arise from the jaw bone and hence are also known as gnathic myxomas. Any other bony myxomas are termed as extragnathic. In view of rarity, uncertain histogenesis, nonspecific clinical features, confusing terminology, and unclear management protocols, the backbone of diagnosis is a thorough histopathologic examination. Only 2 reports on myxomas arising from the frontal sinus have been documented previously. A young man presented with proptosis secondary to a sino-orbital mass lesion arising from the frontal sinus. The patient underwent complete excision biopsy and bone curettage. Following excision, the patient is symptom free at 6 months of follow up and showed no evidence of recurrence.

Actinic granuloma of the conjunctiva in young women.

OBJECTIVE: To report the occurrence of actinic granuloma of the conjunctiva in young women. DESIGN: Retrospective case series. PARTICIPANTS: Three eyes of 3 young women with a unilateral conjunctival mass of recent onset. METHODS: Three young women (21, 23, and 23 years of age) sought treatment for painless red masses of the conjunctiva that were thought clinically to be pingueculitis, actinic keratosis, or ocular surface squamous neoplasia (OSSN), but were diagnosed histopathologically as actinic granuloma. Special stains were performed to exclude infectious and autoimmune causes of granulomatous inflammation, followed by dermatologic work-up and systemic investigations. Diagnosis of actinic granuloma of the conjunctiva was confirmed. MAIN OUTCOME MEASURES: Patients' characteristics (age, sex, early onset), clinical presentation, same geographical location, typical histopathologic features, and lack of systemic association. RESULTS: All 3 cases were in young women with a rapid-onset conjunctival growth with conjunctival feeder vessels and intrinsic vessels; however, there was no surface keratin, and rose bengal stain results were negative. Histopathologic analysis of all 3 cases revealed elastolysis and granulomatous inflammation characterized by multinucleated giant cells, some of which displayed elastophagocytosis that was highlighted by Verhoeff-van Giesen elastic stain. There was absence of cytologic atypia of surface epithelium. Mucin stains and special stains for an infectious cause demonstrated negative results. Serologic investigations and systemic work-up results were negative, which excluded any systemic associations with this condition. This led to the final diagnoses of actinic granuloma of the conjunctiva. CONCLUSIONS: Conjunctival actinic granuloma is an underrecognized entity. We present 3 cases of this condition to highlight its occurrence in young women and the role of histopathologic examination to avoid misinterpretation of this condition. Both clinician and pathologist should consider this entity as a differential diagnosis of benign conjunctival lesions and OSSN. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

The Spectrum of Pathogenic Yeast Infection in a Tertiary Care Hospital in Assam, India.

CONTEXT: In view of the growing incidence of pathogenic yeast infection all over the world, this study was undertaken to understand its etiology and epidemiology in Assam. AIMS: To characterize and study the antifungal susceptibility pattern of the pathogenic yeasts from the clinical samples. SETTINGS AND DESIGN: The study was a hospital-based cross-sectional study. METHODS AND MATERIAL:  150 patients were enrolled in the study and from which clinical samples were collected. A total of 83 samples showing the growth of yeast in culture were included in the study. The yeasts were identified by conventional and BioMerieux ID 32C and VITEK 2TM. Antifungal susceptibility test was done by disk diffusion method as per Clinical and Laboratory Standards Institute (CLSI), M44-A2. STATISTICAL ANALYSIS USED:  Data was analyzed using statistical software Epi-Info 7.1.2.0 (2013; CDC, Atlanta, USA). For comparison of categorical data, the Chi-square test or Fisher exact test was used. A value of p less than 0.05 was considered statistically significant. RESULTS:  The most affected population was the age group of ≤10 years (32.5%) with male preponderance (67.5%). Yeasts were mostly isolated bloodstream infections (49.3%). The major risk factor was prolonged antibiotic intake. Predominant yeast isolates were Candida albicans (43.4%) followed by Candida tropicalis (19.3%). Emerging yeasts like Kodaemea ohmeri (4.8%), Pichia anomala (2.4%), and Candida auris (1.2%) were also isolated. Amphotericin B was effective against all yeast isolates. All the isolates of Candida krusei were resistant to all the azoles. CONCLUSIONS:  The study reflects that there is a growing incidence of emerging yeast infections and efforts are to be made for their identification and antifungal susceptibility testing for the initiation of appropriate therapy.

Trichilemmal cyst of the eyelid: masquerading as recurrent chalazion.

A 52-years-old female presented with a history of a painless, progressive swelling in the left lower eyelid of one-year duration. The lesion was excised twice as a chalazion and recurred. Excisional biopsy of the mass was performed and histopathological findings were consistent with those of trichilemmal cyst. We report a rare case of trichilemmal cyst of the eyelid which was masquerading as chalazion for which the patient had undergone multiple surgeries. Wide excision was done and diagnosis was confirmed on histopathology. There was no recurrence seen till 2 months of postoperative period. Trichilemmal cyst, although rare, should be considered as differential diagnosis of recurrent chalazion.