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ORIGINAL ARTICLE
Year : 2014  |  Volume : 3  |  Issue : 1  |  Page : 12-14

Spectrum of histopathological study of ocular lesions: One year study


Department of Pathology, Prathima Institute of Medical Sciences, Karimnagar, Andhra Pradesh, India

Date of Web Publication10-Mar-2014

Correspondence Address:
Shastry Srikanth
Department of Pathology, Prathima Institute of Medical Sciences, Karimnagar, Andhra Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2277-8632.128417

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  Abstract 

Introduction: Ocular tissues contribute to lesions from inflammation to different types of neoplastic conditions. Histopathology remains the main stay of diagnosis. The study was carried out to know the histopathological diagnosis of various ocular lesions.
Materials and Methods: This is a retrospective and prospective study of ocular lesions done on patients who were referred for ocular examination. Cases were analyzed in detail regarding clinical examination and other findings.
Results: Ocular lesions from 81 patients were analyzed. Basal cell carcinoma (BCC) was the most common neoplastic disorder. Nevus was the most common non-neoplastic disorder. Among the 81 cases, 47 were male and 34 were female patients with the highest number of cases in the age group of 41-50 years.
Conclusion: The most common ocular malignancy was BCC and nevus was the non-neoplastic disorder.

Keywords: Basal cell carcinoma, nevi, ocular lesions


How to cite this article:
Srikanth S. Spectrum of histopathological study of ocular lesions: One year study. J NTR Univ Health Sci 2014;3:12-4

How to cite this URL:
Srikanth S. Spectrum of histopathological study of ocular lesions: One year study. J NTR Univ Health Sci [serial online] 2014 [cited 2020 Apr 4];3:12-4. Available from: http://www.jdrntruhs.org/text.asp?2014/3/1/12/128417


  Introduction Top


Histopathology remains the main stay of diagnosis in tumoral growths. [1],[2],[3],[4],[5] In addition to determining the malignant potential of the lesion, histology reveals its exact nature and structure. Various tissues of visual system contribute to lesions from inflammation to different types of neoplastic conditions. Ocular malignant tumors are relatively rare compared with other eye lesions, require immediate diagnosis and management. However ignorant care due to unawareness of persons can result into debility and loss of vision. The present study was undertaken to analyze the histopathological diagnosis of ocular lesions by retrieving the hospital based data of the patients.


  Materials and Methods Top


A retrospective and prospective study of patients with ocular complaints consulted the Ophthalmologist where all history, clinical examination, investigations and surgical interventions were done. The biopsy specimen of eye and adnexa were submitted to the Department of Pathology during the period of 1 year [March-Feb].


  Results Top


A total of 81 patients who underwent biopsy for ocular lesions were analyzed. [Table 1] shows the age distribution of these patients. [Table 2] shows the sex distribution of study population. [Table 3] shows the diagnosis of study population. In the present study, nevus contributed highest number of cases among the non-neoplastic ocular lesions [Figure 1]. Basal cell carcinoma (BCC) was the most common malignant ocular lesion [Figure 2]. Other lesions include miebomian carcinoma, squamous cell carcinoma (SCC), malignant melanoma, keratocanthoma, seborrheic keratosis, chalazion and dermoid cyst.
Table 1: Age distribution


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Table 2: Sex distribution


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Table 3: The diagnosis of occular lesions


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Figure 1: (a and b) Section showing nevi cells arranged in nests in the dermoepidermal junction (H and E, ×10 ×40). Impression - nevus

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Figure 2: (a and b) Section showing tumor tissue arranged in nests and cords having peripheral palisading and divided into clefts (H and E, ×40). Impression - basal cell carcinoma

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Among the 81 cases 47 were male and 34 were female patients with highest number of cases in the age group of 41-50 years. There were 43 left eye lesions and 38 right eye involvement. None of the cases had bilateral involvement. Lower eye lid is involved in 43 cases.

In the present study, data was analyzed to know the relative frequencies of different ocular lesions. The most common malignancy in the present study was BCC [Figure 2] followed by SCC. Nevus was the most common non-malignant lesion [Figure 1] followed by chalazion, dermoid cyst, keratoacanthoma [Figure 3] and seborrheic keratosis. Other malignant lesions include malignant melanoma [Figure 4]a and b and meibomian gland carcinoma [Figure 5]a, b and [Figure 6]a, b.
Figure 3: (a) Section showing tumor tissue with the epidermis showing crater like arrangement (H and E, ×40). (b) Section showing epidermis with underlying dermis showing skin adnexal structures (H and E, ×40). Impression-keratocanthoma

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Figure 4: (a) Section showing tumor tissue arranged in nests, sheets with melanin pigmentation (H and E, ×40). (b) Section showing tumor tissue showing keratin whorls (H and E, ×40). Impression-malignant melanoma

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Figure 5: (a) Photograph showing fungating growth in right lower lid. (b) Scrapings from the same patient showing tumor cells arranged in sheets with inconspicuous nucleoli (H and E, ×40). Impression-meibomian gland carcinoma

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Figure 6: (a and b) Section showing tumor tissue arranged in sheets, mild pleomorphic nucleoli with prominent nucleoli histopathology [H&E,×10,×40]. Impression-meibomian gland carcinoma

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  Discussion Top


Ophthalmic neoplasms are an important cause of morbidity and mortality. In this era of human immunodeficiency virus pandemic, an increase in the frequency of acquired immunodeficiency syndrome (AIDS)-related ophthalmic neoplasms has been reported. Several studies have documented that 50-75% of adult patients with AIDS will experience ocular complications. [6]

BCC accounts for 90% of all the eyelid malignancies. BCC is 16 times more common than sebaceous carcinoma, the second most common malignancy and 18.5 times more common than SCC. SCC accounts for 9% of the eyelid malignancy. [7] Primary melanomas of the eyelid are rare and accounts for <1% of all eyelid malignancies. Meibomian gland carcinoma is a lethal eyelid malignancy and carries a significant mortality rate with metastasis. Nevocellular nevi are benign proliferations of melanocytic cells, which is the most common lesion in our study. The intradermal nevus is by far the most common nevus seen on the eyelid. Dermoids in and around the eye are usually comprised of skin adnexae and fat. Keratoacanthoma is the most common lesion in Sun exposed and hair bearing area although periocular involvement is not so common.

Orbital lesions are not easily accessible and a firm clinical diagnosis requires a detailed history, clinical examination and investigations. The high expense and lack of adequate facilities for imaging techniques may be responsible for the low clinicopathological correlation observed in orbital lesions.


  Conclusion Top


Nevus was the most common non-neoplastic and BCC was the commonest malignant lesion in the present study.

 
  References Top

1.Scat Y, Liotet S, Carre F. Epidemiological study of 1705 malignant tumors of the eye and adnexa. J Fr Ophtalmol 1996;19:83-8.  Back to cited text no. 1
    
2.Swanson MW, Cloud G. A retrospective analysis of primary eye cancer at the University of Alabama at Birmingham 1958-1988. Part I: Eye and orbital cancer. J Am Optom Assoc 1991;62:815-9.  Back to cited text no. 2
    
3.Thakur SK, Sah SP, Lakhey M, Badhu BP. Primary malignant tumours of eye and adnexa in Eastern Nepal. Clin Experiment Ophthalmol 2003;31:415-7.  Back to cited text no. 3
    
4.Ajaiyeoba IA, Pindiga HU, Akang EE. Tumours of the eye and orbit in Ibadan. East Afr Med J 1992;69:487-9.  Back to cited text no. 4
    
5.Sunderraj P. Malignant tumours of the eye and adnexa. Indian J Ophthalmol 1991;39:6-8.  Back to cited text no. 5
[PUBMED]  Medknow Journal  
6.Sarraf D, Ernest JT. AIDS and the eyes. Lancet 1996;348:525-8.  Back to cited text no. 6
    
7.Chuka-Okosa CM, Uche NJ, Kizor-Akaraiwe NN. Orbito-ocular neoplasms in Enugu, South-Eastern, Nigeria. West Afr J Med 2008;27:144-7.  Back to cited text no. 7
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]
 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

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Abstract
Introduction
Materials and Me...
Results
Discussion
Conclusion
References
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