Difference between revisions of "Pterygium"

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{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Pterygium_-_high_mag.jpg
| Width      =
| Caption    = Pterygium. [[H&E stain]].
| Synonyms  = surfer eye
| Micro      = hyaline material beneath epithelium, elastic fibres beneath the hyaline material, +/-inflammation, [[solar elastosis]], dilated [[blood vessels]]
| Subtypes  =
| LMDDx      = squamous dysplasia, [[squamous cell carcinoma]]
| Stains    =
| IHC        =
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Site      = [[eye]] - more specifically ''conjunctiva''
| Assdx      =
| Syndromes  =
| Clinicalhx = sun exposure
| Signs      =
| Symptoms  =
| Prevalence = common
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  = benign
| Other      = [[pinguecula]] considered early pterygium by some
| ClinDDx    =
| Tx        = excision
}}
'''Pterygium''' is a common benign pathology of the [[eye]]. It is also known as '''surfer eye'''.
'''Pterygium''' is a common benign pathology of the [[eye]]. It is also known as '''surfer eye'''.


It is similar to [[pinguecula]] and Raizada ''et al.''<ref name=pmid1031388>{{Cite journal  | last1 = Raizada | first1 = IN. | last2 = Bhatnagar | first2 = NK. | title = Pinguecula and pterygium (a histopathological study). | journal = Indian J Ophthalmol | volume = 24 | issue = 2 | pages = 16-8 | month = Jul | year = 1976 | doi =  | PMID = 1031388 | URL = http://www.ijo.in/text.asp?2007/55/1/83/29517 }}</ref> suggest ''pinguecula'' is an early [[pterygium]]; however, this is disputed.
It is similar to [[pinguecula]] and Raizada ''et al.''<ref name=pmid1031388>{{Cite journal  | last1 = Raizada | first1 = IN. | last2 = Bhatnagar | first2 = NK. | title = Pinguecula and pterygium (a histopathological study). | journal = Indian J Ophthalmol | volume = 24 | issue = 2 | pages = 16-8 | month = Jul | year = 1976 | doi =  | PMID = 1031388 | URL = http://www.ijo.in/text.asp?2007/55/1/83/29517 }}</ref> suggest ''pinguecula'' is an early pterygium; however, this is disputed.


==General==
==General==
*Pronounced: "tuh-rij-ee-uhm".<ref>URL: [http://dictionary.reference.com/browse/pterygium http://dictionary.reference.com/browse/pterygium]. Accessed on: 20 October 2011</ref>
*Pronounced: "tuh-rij-ee-uhm".<ref>URL: [http://dictionary.reference.com/browse/pterygium http://dictionary.reference.com/browse/pterygium]. Accessed on: 20 October 2011</ref>
*Conjunctiva lesion that covers part of the sclera.
*Conjunctiva lesion that covers part of the sclera.
**Sclera = white part of the eye.<ref>URL: [http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002006/ http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002006/]. Accessed on: 20 October 2011.</ref>
**[[Sclera]] = white part of the eye.<ref>URL: [http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002006/ http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002006/]. Accessed on: 20 October 2011.</ref>
*Benign.
*Benign.
*Due to ultraviolet light exposure, i.e. sunlight.<ref name=pmid2695353>{{Cite journal  | last1 = Hill | first1 = JC. | last2 = Maske | first2 = R. | title = Pathogenesis of pterygium. | journal = Eye (Lond) | volume = 3 ( Pt 2) | issue =  | pages = 218-26 | month =  | year = 1989 | doi = 10.1038/eye.1989.31 | PMID = 2695353 | URL = http://www.nature.com/eye/journal/v3/n2/abs/eye198931a.html }}</ref>
*Due to ultraviolet light exposure, i.e. sunlight.<ref name=pmid2695353>{{Cite journal  | last1 = Hill | first1 = JC. | last2 = Maske | first2 = R. | title = Pathogenesis of pterygium. | journal = Eye (Lond) | volume = 3 ( Pt 2) | issue =  | pages = 218-26 | month =  | year = 1989 | doi = 10.1038/eye.1989.31 | PMID = 2695353 | URL = http://www.nature.com/eye/journal/v3/n2/abs/eye198931a.html }}</ref>
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*Medial aspect of eye - covers sclera (white part) and part of the iris (coloured part).
*Medial aspect of eye - covers sclera (white part) and part of the iris (coloured part).


Image:
===Image===
*[http://trialx.com/curebyte/2011/05/31/what-does-pterygium-look-like/ Pterygium - gross (trialx.com)].
<gallery>
Image:Pterygium (from Michigan Uni site, CC-BY).jpg |Pterygium. (WC/Jonathan Trobe)
</gallery>


==Microscopic==
==Microscopic==
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**Dense gray/light brown acellular material.
**Dense gray/light brown acellular material.
*Dilated vessels.<ref name=uic_edu>URL: [http://www.uic.edu/depts/mcpt/eyepath/specco4.htm http://www.uic.edu/depts/mcpt/eyepath/specco4.htm]. Accessed on: 25 October 2011.</ref>
*Dilated vessels.<ref name=uic_edu>URL: [http://www.uic.edu/depts/mcpt/eyepath/specco4.htm http://www.uic.edu/depts/mcpt/eyepath/specco4.htm]. Accessed on: 25 October 2011.</ref>
Note:
*Goblet cells within the squamous epithelium are expected; normal [[conjunctiva]] has goblet cells.


DDx:
DDx:
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Image:Pterygium_-_high_mag.jpg | Pterygium - high mag. (WC/Nephron)
Image:Pterygium_-_high_mag.jpg | Pterygium - high mag. (WC/Nephron)
</gallery>
</gallery>
==Sign out==
==Sign out==
===Right eye===
===Right eye===

Latest revision as of 15:02, 9 June 2016

Pterygium
Diagnosis in short

Pterygium. H&E stain.
Synonyms surfer eye
LM hyaline material beneath epithelium, elastic fibres beneath the hyaline material, +/-inflammation, solar elastosis, dilated blood vessels
LM DDx squamous dysplasia, squamous cell carcinoma
Site eye - more specifically conjunctiva
Clinical history sun exposure
Prevalence common
Prognosis benign
Other pinguecula considered early pterygium by some
Treatment excision

Pterygium is a common benign pathology of the eye. It is also known as surfer eye.

It is similar to pinguecula and Raizada et al.[1] suggest pinguecula is an early pterygium; however, this is disputed.

General

  • Pronounced: "tuh-rij-ee-uhm".[2]
  • Conjunctiva lesion that covers part of the sclera.
  • Benign.
  • Due to ultraviolet light exposure, i.e. sunlight.[4]

Gross

  • Medial aspect of eye - covers sclera (white part) and part of the iris (coloured part).

Image

  • Pterygium. (WC/Jonathan Trobe)

Microscopic

Features:[4]

  • Hyaline material beneath epithelium.
  • Elastic fibres beneath the hyaline material.
  • +/-Inflammation.
  • Solar elastosis.[5]
    • Dense gray/light brown acellular material.
  • Dilated vessels.[5]

Note:

  • Goblet cells within the squamous epithelium are expected; normal conjunctiva has goblet cells.

DDx:

Images

www:

  • Pterygium - intermed. mag. (WC/Nephron)

  • Pterygium - high mag. (WC/Nephron)

Sign out

Right eye

Right Eye, Conjunctiva (Submitted as "Pterygium"), Excision:
- Conjunctival mucosa with solar elastosis and dilated superficial blood vessels, compatible with pterygium.
- NEGATIVE for dysplasia.

Inflammation present

Right Eye, Conjunctiva (Submitted as "Left Pterygium"), Excision:
- Conjunctival mucosa with solar elastosis, mild inflammation and dilated superficial blood 
  vessels, compatible with pterygium.
- NEGATIVE for dysplasia.

No solar elastosis

Right Eye, Conjunctiva (Submitted as "Right Pterygium"), Excision:
- Conjunctival mucosa with dilated superficial blood vessels and 
  benign mild stromal changes.  
- NEGATIVE for dysplasia.

Block letters

CONJUNCTIVA ("PTERYGIUM"), RIGHT, EXCISION:
- CONJUNCTIVAL MUCOSA WITH STROMAL ACTINIC CHANGES -- CONSISTENT WITH PTERYGIUM.

CONJUNCTIVA ("PTERYGIUM"), RIGHT, EXCISION:
- CONJUNCTIVAL MUCOSA WITH STROMAL ACTINIC CHANGES -- CONSISTENT WITH PTERYGIUM.
- NEGATIVE FOR DYSPLASIA.

CONJUNCTIVA ("PTERYGIUM"), RIGHT EYE, EXCISION:
- CONJUNCTIVAL MUCOSA WITH SOLAR ELASTOSIS AND DILATED SUPERFICIAL BLOOD VESSELS -- CONSISTENT WITH PTERYGIUM.
- NEGATIVE FOR DYSPLASIA.

Left eye

CONJUNCTIVA ("PTERYGIUM"), LEFT EYE, EXCISION:
- CONJUNCTIVAL MUCOSA WITH SOLAR ELASTOSIS AND DILATED SUPERFICIAL BLOOD VESSELS -- CONSISTENT WITH PTERYGIUM.
- NEGATIVE FOR DYSPLASIA.

See also

References

  1. ↑ Raizada, IN.; Bhatnagar, NK. (Jul 1976). "Pinguecula and pterygium (a histopathological study).". Indian J Ophthalmol 24 (2): 16-8. PMID 1031388.
  2. ↑ URL: http://dictionary.reference.com/browse/pterygium. Accessed on: 20 October 2011
  3. ↑ URL: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002006/. Accessed on: 20 October 2011.
  4. ↑ 4.0 4.1 Hill, JC.; Maske, R. (1989). "Pathogenesis of pterygium.". Eye (Lond) 3 ( Pt 2): 218-26. doi:10.1038/eye.1989.31. PMID 2695353.
  5. ↑ 5.0 5.1 URL: http://www.uic.edu/depts/mcpt/eyepath/specco4.htm. Accessed on: 25 October 2011.
  6. ↑ Clear, AS.; Chirambo, MC.; Hutt, MS. (Feb 1979). "Solar keratosis, pterygium, and squamous cell carcinoma of the conjunctiva in Malawi.". Br J Ophthalmol 63 (2): 102-9. PMC 1043407. PMID 427069. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1043407/.
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