Difference between revisions of "Eye"

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===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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==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.
*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>
**Most common is [[nevus]] ~ 50% of caruncle tumours.
 
===Gross===
*Frond-like lesion.
 
Image:
*[http://www.atlasophthalmology.com/atlas/photo.jsf?node=2748&locale=en Papilloma of caruncle (atlasophthalmology.com)].
 
===Microscopic===
Features:<ref name=pmid16935590/>
*Fibrovascular fronds in a cauliflower-like arrangement.
*No nuclear atypia.
 
Image:
*[http://www.atlasophthalmology.com/atlas/photo.jsf?node=4686&locale=en Papilloma of caruncle - crappy image (atlasophthalmology.com)].
 
===Sign out===
<pre>
LESION, RIGHT CARUNCLE, EXCISION:
- PAPILLOMA.
- NEGATIVE FOR MALIGNANCY.
</pre>
 
====Micro====
The sections show benign conjunctival mucosa and a lesion consisting of fibrovascular
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===
*[http://eyewiki.aao.org/Conjunctival_Papilloma Conjunctival papilloma (eyewiki.aao.org)].


==Corneal ulcer==
==Corneal ulcer==
===General===
{{Main|Corneal ulcer}}
*Cause: trauma.<ref name=pmid26319343>{{Cite journal  | last1 = Ahmed | first1 = F. | last2 = House | first2 = RJ. | last3 = Feldman | first3 = BH. | title = Corneal Abrasions and Corneal Foreign Bodies. | journal = Prim Care | volume = 42 | issue = 3 | pages = 363-75 | month = Sep | year = 2015 | doi = 10.1016/j.pop.2015.05.004 | PMID = 26319343 }}</ref>
*May threaten sight in the eye.<ref name=pmid26319343/>
 
===Microscopic===
Feature:
*Ulceration of squamous epithelium.{{fact}}
 
DDx:
*[[Squamous dysplasia]].


===Sign out===
==Keratoconus==
<pre>
{{Main|Keratoconus}}
Corneal Button, Left Eye, Keratoplasty:
- Corneal ulcer associated with neovascularization and chronic inflammation.
- NEGATIVE for dysplasia.
</pre>


==Corneal scar==
==Corneal scar==
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- NEGATIVE for dysplasia.
- NEGATIVE for dysplasia.
</pre>
</pre>
==Conjunctival nevus==
{{Main|Conjunctival nevus}}


=Tumours of the eye=
=Tumours of the eye=
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==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==
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