Difference between revisions of "Eye"

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Eye (view source)

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[[Image:Gray888.png|thumb|200px|Illustration of the eye. (Gray's Anatomy/WC)]]
[[Image:Gray888.png|thumb|300px|Illustration of the eye. (Gray's Anatomy/WC)]]
[[Image:Optic nerve head and retina -- low mag.jpg|thumb|300px|Micrograph showing the optic nerve head and retina. [[H&E stain]]. (WC)]]
The '''eye''' is rarely seen by pathologists.  Typically, they go to neuropathologists, as the eye is really part of the brain.  The article also covers many of the lesions found around the eye.  The lacrimal gland is covered in the ''[[lacrimal gland]]'' article.  Eyelid lesions are covered in the ''[[eyelid]]'' article.   
The '''eye''' is rarely seen by pathologists.  Typically, they go to neuropathologists, as the eye is really part of the brain.  The article also covers many of the lesions found around the eye.  The lacrimal gland is covered in the ''[[lacrimal gland]]'' article.  Eyelid lesions are covered in the ''[[eyelid]]'' article.   


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*Surrounded by CSF.
*Surrounded by CSF.
*Covered by dura.
*Covered by dura.
====Images====
<gallery>
Image: Optic nerve -- very low mag.jpg | CN II - very low mag. (WC)
Image: Optic nerve -- low mag.jpg | CN II - low mag. (WC)
Image: Optic nerve -- intermed mag.jpg | CN II - intermed. mag. (WC)
Image: Optic nerve -- high mag.jpg | CN II - high mag. (WC)
</gallery>


===Inside to outside===
===Inside to outside===
Line 27: Line 36:
#Choroid.
#Choroid.
#Sclera.
#Sclera.
====Image====
<gallery>
Image:Optic nerve head and retina -- low mag.jpg| Optic nerve head and retina - low mag. (WC)
</gallery>


===Anterior angle===
===Anterior angle===
*Angle between cornea and iris.
*Angle between cornea and iris.
===Canthi===
The canthi are where the upper and lower eyelids meet:
*Medial canthus.
*Lateral canthus.
Note:
*The most common malignant canthus lesion is [[basal cell carcinoma]].<ref>URL: [https://iovs.arvojournals.org/article.aspx?articleid=2372910 https://iovs.arvojournals.org/article.aspx?articleid=2372910]. Accessed on: 2022 Nov 17.</ref>


=Histology=
=Histology=
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===Retina===
===Retina===
[[Image:Retina -- very high mag.jpg|thumb|right|300px|Retina. (WC)]]
Simplified structure - eosinophilic material separating:
Simplified structure - eosinophilic material separating:
#Intermediate size, round, pale-staining nuclei (ganglion cells).
#Intermediate size, round, pale-staining nuclei (ganglion cells).
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<gallery>
<gallery>
Image:Gray881.png | Retina - schematic. (WC/Gray's)
Image:Gray881.png | Retina - schematic. (WC/Gray's)
Image: Optic nerve head and retina -- low mag.jpg | Optic nerve & retina - low mag. (WC)
Image: Retina -- intermed mag.jpg | Retina - intermed. mag. (WC)
Image: Retina -- high mag.jpg | Retina - high mag. (WC)
</gallery>
</gallery>
www:
www:
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==Eccrine hidrocystoma==
==Eccrine hidrocystoma==
*Occasionally spelled ''eccrine hydrocystoma''.<ref name=pmid10065300/>
*Occasionally spelled ''eccrine hydrocystoma''.<ref name=pmid10065300/>
===General===
{{Main|Eccrine hidrocystoma}}
*Benign.
*Eyelid lesion.
 
Clinical DDx:<ref name=pmid10065300/>
*Cystic [[BCC]].
 
===Microsopic===
Features:<ref name=pmid15205675>{{Cite journal  | last1 = Singh | first1 = AD. | last2 = McCloskey | first2 = L. | last3 = Parsons | first3 = MA. | last4 = Slater | first4 = DN. | title = Eccrine hidrocystoma of the eyelid. | journal = Eye (Lond) | volume = 19 | issue = 1 | pages = 77-9 | month = Jan | year = 2005 | doi = 10.1038/sj.eye.6701404 | PMID = 15205675 }}</ref><ref>{{Ref Derm|314}}</ref>
*Cyst lined by a bland bilayer.
**Inner lining cells have:
***Small, round nuclei - usu. basal.
***Moderate pale/greyish cytoplasm.
***No apocrine snouts - flat surface.
**Outer lining cells - spindled.
***May be difficult to see.
 
Note:
*According to the CMAJ, it has the histology of an [[epidermal inclusion cyst]].<ref name=pmid10065300>{{Cite journal  | last1 = Adams | first1 = SP. | title = Dermacase. Eccrine hydrocystoma. | journal = Can Fam Physician | volume = 45 | issue =  | pages = 297, 306 | month = Feb | year = 1999 | doi =  | PMID = 10065300 |PMC = 2328272 }}</ref>
 
DDx:
*[[Apocrine hidrocystoma]] - have apocrine snouts; surface is ''not'' flat.
*Cystadenoma - has epithelial proliferation.
 
====Image====
<gallery>
Image:SkinTumors-P7110453.JPG | Apocrine hidrocystoma (AH). AH looks similar to ''eccrine hidrocystoma''. (WC)
</gallery>
www:
*[http://www.nature.com/eye/journal/v19/n1/fig_tab/6701404f1.html Eccrine hidrocystoma (nature.com)].
*[http://www.dermnet.org.nz/pathology/apocrine-hidrocystoma-path.html Apocrine hidrocystoma (dermnet.org)].
*[http://www.flickr.com/photos/42574434@N03/9519309216 Apocrine hidrocystoma (flickr.com)].
 
===Sign out===
<pre>
SKIN LESION, ADJACENT TO RIGHT EYELID, EXCISION:
- ECCRINE HIDROCYSTOMA.
</pre>
 
====Micro====
The sections show hair bearing skin with a cyst lined by a bland bilayered epithelium.  The predominant lining cell has moderate pale grey cytoplasm and a small round nucleus. 
 
The lesion is excised in the plane of section.


==Chalazion==
==Chalazion==
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==Papilloma of the caruncle==
==Papilloma of the caruncle==
*[[AKA]] ''caruncle papilloma''.
{{Main|Eye papilloma}}
===General===
 
*Benign.
==Corneal ulcer==
*Second most common caruncle tumour ~ 15% of caruncle tumours.<ref name=pmid16935590>{{Cite journal  | last1 = Kaeser | first1 = PF. | last2 = Uffer | first2 = S. | last3 = Zografos | first3 = L. | last4 = Hamédani | first4 = M. | title = Tumors of the caruncle: a clinicopathologic correlation. | journal = Am J Ophthalmol | volume = 142 | issue = 3 | pages = 448-55 | month = Sep | year = 2006 | doi = 10.1016/j.ajo.2006.04.035 | PMID = 16935590 }}</ref>
{{Main|Corneal ulcer}}
**Most common is [[nevus]] ~ 50% of caruncle tumours.


===Gross===
==Keratoconus==
*Frond-like lesion.
{{Main|Keratoconus}}


Image:
==Corneal scar==
*[http://www.atlasophthalmology.com/atlas/photo.jsf?node=2748&locale=en Papilloma of caruncle (atlasophthalmology.com)].
===General===
*Trauma to the cornea.


===Microscopic===
===Microscopic===
Features:<ref name=pmid16935590/>
Features:
*Fibrovascular fronds in a cauliflower-like arrangement.
*Compact hyaline tissue - darker staining.
*No nuclear atypia.
*Fibroblasts.


Image:
DDx:
*[http://www.atlasophthalmology.com/atlas/photo.jsf?node=4686&locale=en Papilloma of caruncle - crappy image (atlasophthalmology.com)].  
*Squamous dysplasia.


===Sign out===
===Sign out===
<pre>
<pre>
LESION, RIGHT CARUNCLE, EXCISION:
Corneal Button, Right Eye, Keratoplasty:
- PAPILLOMA.
- Consistent with corneal scar.
- NEGATIVE FOR MALIGNANCY.
- NEGATIVE for dysplasia.
</pre>
</pre>


====Micro====
==Conjunctival nevus==
The sections show benign conjunctival mucosa and a lesion consisting of fibrovascular
{{Main|Conjunctival nevus}}
cores covered by a conjunctival epithelium with a cauliflower-like appearance at low
power. Parakeratosis is present. No significant nuclear atypia is identified. No koilocytic
change is seen. No mitotic activity is appreciated.


===External links===
=Tumours of the eye=
*[http://eyewiki.aao.org/Conjunctival_Papilloma Conjunctival papilloma (eyewiki.aao.org)].
==Optic glioma==
===General===
*Associated with [[Neurofibromatosis]] type 1.
* Often nerve sheath thickening or tortuosity.
* Approx 3% of all pediatric gliomas.
* Histology in most cases a [[pilocytic astrocytoma]].


=Malignant entities=
==Retinoblastoma==
==Retinoblastoma==
===General===
{{Main|Retinoblastoma}}
*Rare.
*Malignant.
*May be familial.<ref name=pmid20687510>{{cite journal |author=Lohmann D |title=Retinoblastoma |journal=Adv. Exp. Med. Biol. |volume=685 |issue= |pages=220–7 |year=2010 |pmid=20687510 |doi= |url=}}</ref>
 
===Gross===
*White, solid.
*Patterns:
**Endophytic - grow into the  vitreous cavity.
**Exophytic - grow toward choroid.
**Mixed - components of endophytic and exophytic.
 
Image:
*[http://radiopaedia.org/cases/retinoblastoma-gross-pathology Retinoblastoma (radiopaedia.org/AFIP)].
 
Note:
*Tumour is extremely friable.
 
===Microscopic===
Features:
*[[Small round cell tumour]]:
**Scant cytoplasm.
*Flexner-Wintersteiner [[rosette]] - '''key feature'''.
**Rosette with empty centre (donut hole).<ref name=pmid16551982>{{cite journal |author=Wippold FJ, Perry A |title=Neuropathology for the neuroradiologist: rosettes and pseudorosettes |journal=AJNR Am J Neuroradiol |volume=27 |issue=3 |pages=488–92 |year=2006 |month=March |pmid=16551982 |doi= |url=}}</ref>
*+/-Homer-Wright rosette.<ref>WH. 14 March 2011.</ref>
**Circular rosette with neuropil at the centre.<ref name=pmid16551982>{{cite journal |author=Wippold FJ, Perry A |title=Neuropathology for the neuroradiologist: rosettes and pseudorosettes |journal=AJNR Am J Neuroradiol |volume=27 |issue=3 |pages=488–92 |year=2006 |month=March |pmid=16551982 |doi= |url=}}</ref>
*Mitoses - common.
*+/-Necrosis.
*+/-Calcification.
 
DDx:
*Retinocytoma (retinoma) - benign counterpart of retinoblastoma.
 
Notes:
*DDx of Flexner-Wintersteiner rosette includes:
**Pineoblastoma.
**Medulloepithelioma.
 
Image:
*[http://moon.ouhsc.edu/kfung/jty1/opaq/PathQuiz/O0A001-PQ01-M.htm Retinoblastoma (ouhsc.edu)].
*[http://www.pathpedia.com/Education/eAtlas/Histopathology/eye_and_ocular_adnexa/retinoblastoma.aspx Retinoblastoma (pathpedia.com)].


==Malignant melanoma==
==Malignant melanoma==
Michael
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