ocular path dr dody(1).ppt

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OCULAR PATHOLOGY CASECONFERENCE



Case #3



Case #3 (cont’d)



Case 3: Basal Cell Carcinoma



• 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



Case 3: Basal Cell Carcinoma



• S08-16580

• BCC



Case #5



Case #5 (cont’d)



Case #5 (cont’d)



Case 5: capillary hemangioma



• 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



Case 5: capillary hemangioma



Case #6



Case #6 (cont’d)



Case #6 (cont’d)





Case 6: vascular malformation,

possibly arteriovenous

masson



Case 6: vascular malformation,

possibly arteriovenous

masson



Case #7



Case #7 (cont’d)



Case #7

(cont’d)



Case 7: dermoid



• 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





Case 8: Retinoblastoma



• P07-860 unilateral

• Retinoblastoma











• P07-860

• Retinoblastoma




PAS



• 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





• 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





Case #9 (cont’d)





Case #9 (cont’d)



Case 9: Embryonal rhabdomyosarcoma





Case 9: Embryonal rhabdomyosarcoma



• P08-970

• Embryonal rhabdomyosarcoma



Case 9: embryonal rhabdomyosarcoma

desmin myoD1 myogenin



• P08-970

• Embryonal rhabdomyosarcoma

• Identlify myoglobin constituent within suspect

tumor cells



Case #10



Case #10 (cont’d)





Case 10: cavernous hemangioma



• 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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ocular path dr dody(1).ppt