ocular path dr dody(1).ppt
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8/10/2019 ocular path dr dody(1).ppt
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OCULAR PATHOLOGY CASECONFERENCE
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Case #3
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Case #3 (cont’d)
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Case 3: Basal Cell Carcinoma
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• S08-16580 63F fungating mass L eye; exenteration;involvement of L orbit
• Biopsy proven basal cell carcinoma: BCC
• Nodular infiltratice BCC; invasive into mm. SQ tissue and
focally involving sclera and conjunctiva• Most common tumor involving eyelids, especially lower
• More common in Caucasians with extensive sunlightexposure
• Palisading tumor cells at the periphery of tumor cell nests
• “rodent ulcer” gross appearance with rolled endges andulcerated center
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Case 3: Basal Cell Carcinoma
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• S08-16580
• BCC
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Case #5
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Case #5 (cont’d)
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Case #5 (cont’d)
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Case 5: capillary hemangioma
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• P08-987 16mo F giant vascular lesion inferior orbit
• Capillary hemangioma: hemangioma of infancy
• With lymphangiomas are the most common vasculartumors of the orbit in children
• Poorly circumscribed and unencapsulated• Composed of plexus of capillary caliber vessels
• Early lesions composed of predominately solid sheet ofendothelial cells; vascular lesions become progressivelyectatic as the lesion matures with enlarged capillary lumens
• Eyelid lesions look like strawberry red nevi; those confinedto the orbit may be more subtle with proptosis and bluishskin discoloration
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Case 5: capillary hemangioma
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Case #6
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Case #6 (cont’d)
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Case #6 (cont’d)
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Case 6: vascular malformation,
possibly arteriovenous
masson
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Case 6: vascular malformation,
possibly arteriovenous
masson
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Case #7
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Case #7 (cont’d)
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Case #7
(cont’d)
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Case 7: dermoid
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• P08-1741: 3 yo. Present since birth
• Most common orbital lesion in infants and children
• Entrapment of surface ectoderm in bony sutures during development
• Choristomatous lesions (benign congenital tumor composed of cellular elementsand tissues not usually present at that site)
• usually located in the superotemporal quadrant
• Resemble epidermoid inclusion cysts, but also have epidermal appendages such aspilosebaceous units and sweat glands
• Cyst filled with keratin debris
• Lined by stratified squamous epithelium
• Epidermal appendages resemble skin
• Epidermoid cyst caused by obstruction of the duct of a pilosebaceous follicle.
Lined by stratified squamous epithelium – epidermoid or retention cyst• Dermoid cyst formed when embryonic ectodermal rests are displaced into the lid
or orbit; presence of pilosebaceous follicles in the wall of dermoid cyst
• Usually slowly growing painless masses in upper lid
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Case 8: Retinoblastoma
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• P07-860 unilateral
• Retinoblastoma
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Case 8: Retinoblastoma
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Case 8: Retinoblastoma
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• P07-860
• Retinoblastoma
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Case 8: Retinoblastoma
PAS
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• P07-860
• Retinoblastoma: most common intraocular tumor of childhood
• Rare; 250 cases annually in the US
• Mean age at diagnosis 18 months
• White pupillary reflex: leukocoria
• Flexner-Wintersteiner rosette = circle of cells limited internally bycontinuous membrane
• Homer-Wright: multilayered sircle of nuclei surroundingeosinophilic fibrillar material
• Fleurettes: circular/oval group of cells in which cytoplasmic
processes have ultrastructural characteristics of inner segments ofphotoreceptors
• Tumor spreads along optic nerve
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• P07-860
• Retinoblastoma: most common intraocular
tumor of childhood
• Rare; 250 cases annually in the US
• Mean age at diagnosis 18 months
•
White pupillary reflex: leukocoria
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Case #9 (cont’d)
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Case #9 (cont’d)
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Case 9: Embryonal rhabdomyosarcoma
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Case 9: Embryonal rhabdomyosarcoma
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• P08-970
• Embryonal rhabdomyosarcoma
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Case 9: embryonal rhabdomyosarcoma
desmin myoD1 myogenin
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• P08-970
• Embryonal rhabdomyosarcoma
• Identlify myoglobin constituent within suspect
tumor cells
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Case #10
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Case #10 (cont’d)
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Case 10: cavernous hemangioma
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• S08-8505
• Most common vascular tumor in orbit ofadults is cavernous hemangioma
• Benign slow-growing hamartomas which oftenare well-circumscribed within the orbit
• Red-purple with nodular surface on gross
examination• Usually uniform blood-filled spaces uniform in
size separated by fibrous tissue
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