ABSTRACT
PURPOSE: To evaluate the efficacy, recurrence rate, and long-term complications of topical mitomycin C (MMC) 0.02% for conjunctival-corneal intraepithelial neoplasia (CCIN). METHODS: A prospective, nonrandomized, noncontrolled study was conducted of patients with primary or recurrent CCIN treated with topical MMC 0.02%, four times per day, for 28 consecutive days. The main outcome measures were complete resolution of the neoplasia by slit-lamp examination and cytology 1 month after treatment, tumor recurrence, and long-term complications. RESULTS: Between June 1999 and September 2005, 23 patients were included. Eighteen had primary CCIN (group 1) and 5 had recurrent CCIN (group 2). The mean follow-up was 46 months in group 1 and 54 months in group 2. All patients were treated with MMC 0.02% for 28 consecutive days. Complete resolution of the lesion was achieved in all patients after 1 month of treatment. Recurrence occurred in 1 patient (4.3%) after 24 months of treatment. Four patients developed corneal erosion (17.4%), 2 of them with primary CCIN and 2 with recurrent CCIN. Corneal erosion occurred 4 to 24 months after treatment and was treated successfully. The probability for corneal erosions by the log-rank test was equal for both groups (p = 0.1705). CONCLUSIONS: The use of topical MMC 0.02% for 28 consecutive days to treat primary or recurrent CCIN was effective and showed a low recurrence rate. Corneal erosion occurred in 17.4% of cases and can occur as late as 24 months after treatment.
Subject(s)
Antibiotics, Antineoplastic/administration & dosage , Carcinoma in Situ/drug therapy , Conjunctival Neoplasms/drug therapy , Corneal Diseases/drug therapy , Mitomycin/administration & dosage , Neoplasm Recurrence, Local/drug therapy , Adult , Aged , Aged, 80 and over , Biopsy , Carcinoma in Situ/pathology , Conjunctival Neoplasms/pathology , Corneal Diseases/pathology , Dose-Response Relationship, Drug , Eye Neoplasms/drug therapy , Eye Neoplasms/pathology , Female , Follow-Up Studies , Humans , Male , Middle Aged , Neoplasm Recurrence, Local/pathology , Ophthalmic Solutions , Prospective Studies , Time Factors , Treatment OutcomeSubject(s)
Humans , Male , Middle Aged , Carcinoma, Hepatocellular/secondary , Liver Neoplasms/pathology , Orbital Neoplasms/secondary , Biopsy , Carcinoma, Hepatocellular/diagnosis , Fatal Outcome , Immunochemistry , Liver Neoplasms/diagnosis , Orbital Neoplasms/diagnosis , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: Orbital idiopathic inflammation, lymphoid hyperplasia, and lymphoma may all present clinically in the same manner. Histopathology and especially immunohistochemistry play a major role in the differential diagnosis. The purpose of this study was to determine the immunophenotypic features of these lesions. METHODS: Fifty-five orbital lymphoid lesions were retrieved from the ophthalmic pathology registries at McGill University, Montreal, Canada, and the Federal University of São Paulo, São Paulo, Brazil. Formalin-fixed, paraffin-embedded, histopathologic sections were stained with hematoxylin and eosin and periodic acid-Schiff. The sections were also immunostained for B-cell (CD20) and T-cell (CD43) markers and for immunoglobulin light chains kappa and lambda. Two pathologists determined the histopathologic and immunohistochemical pattern of each lesion in a masked fashion. RESULTS: Of the 55 lesions, 11 (20%) were idiopathic chronic inflammations, 22 (40%) were lymphoid hyperplasias and 22 (40%) were lymphomas. Idiopathic inflammation displayed a predominance of T cells and all lesions expressed polyclonal light chains. Lymphoid hyperplasia displayed a mixture of B cells and T cells, with a slight predominance of the former and all lesions expressed polyclonal light chains. Lymphoma showed a striking predominance of B cells and all lesions expressed monoclonal light chains, usually kappa (63.7%). The differences in the mean percentages of B cells among the orbital lymphoid lesions (inflammation, 35%; hyperplasia, 65.9%; lymphoma, 87.3%) were statistically significant (p < 0.001). INTERPRETATION: Orbital lymphoid lesions can be differentiated based on the percentages of B cells and T cells and the monoclonal or polyclonal expression of immunoglobulin light chains.
Subject(s)
Lymphoma/pathology , Orbital Neoplasms/pathology , Orbital Pseudotumor/pathology , Pseudolymphoma/pathology , Adolescent , Adult , Aged , Antigens, CD20/metabolism , Antigens, CD34/metabolism , B-Lymphocytes/pathology , Biomarkers, Tumor/metabolism , Female , Humans , Immunoglobulin kappa-Chains/metabolism , Immunoglobulin lambda-Chains/metabolism , Immunohistochemistry , Immunophenotyping , Lymphoma/metabolism , Male , Middle Aged , Orbital Neoplasms/metabolism , Orbital Pseudotumor/metabolism , Pseudolymphoma/metabolism , T-Lymphocytes/pathologyABSTRACT
Os autores apresentaram dois casos clinicamente distintos, com diagnóstico histopatológico de amiloidose corneana localizada, sem que padräo familiar e patologias oculares ou sistêmicas associadas pudessem ser identificadas. De acordo com a literatura, os autores fazem o diagnóstico de amiloidose corneana secundária, na qual a provável patologia causal näo foi identificada, mas näo descartam a possibilidade de amiloidose primária localizada da córnea, patologia esta extremamente rara
