Incidence of melanocytic lesions of the conjunctiva in a review of 10 675 ophthalmic specimens.

During the study period, 10,675 human ophthalmic specimens were received at The Henry C. Witelson Ophthalmic Pathology Laboratory and Registry, McGill University, Montreal, Canada. Of those, 271 were conjunctival lesions (2.5%), with 101 being classified as melanocytic: 50 (49.5%) nevi, 36 (35.6%) primary acquired melanoses, and 15 (14.9%) melanomas. After exclusion of referred cases, 85 lesions were included in the study: 44 (51.7%) nevi, 33 (38.8%) primary acquired melanoses, and 8 (9.4%) melanomas. The most prevalent location was the bulbar conjunctiva. Conjunctival melanomas were most commonly found in an older age group than primary acquired melanosis or nevi. Conjunctival nevi were subdivided into compound (32.9%), subepithelial (16.4%), and junctional (2.3%). Primary acquired melanosis were further classified into primary acquired melanosis with atypia (8.2%) and primary acquired melanosis without atypia (30.5%). Primary acquired melanoses was the predisposing lesion in 75% of the cases of melanoma. In our sample, referral bias could alter the distribution of conjunctival pigmented lesions, with a shift toward the malignant end.

Histopathological study of lesions of the caruncle: a 15-year single center review.

INTRODUCTION: The caruncle is a modified cutaneous tissue located at the inner canthus that contains hair follicles, accessory lacrimal glands, sweat glands and sebaceous glands. These different types of tissues can give rise to a wide variety of lesions that make the clinical diagnosis difficult. The aim of the study was to investigate the most common types of caruncle lesions and the clinical and pathological correlation. METHODS: Retrospective, observational case series. Records of caruncle lesions examined at the Henry C. Witelson Ocular Pathology Laboratory, McGill University, Montreal, Canada, between 1993 and 2008 were analyzed, comparing the clinical and histopathological findings. RESULTS: A total of 42 lesions from 42 patients were analyzed. Twenty-six (61.90%) of the patients were women and 16 (38.10%) were men and the age range from 20 to 84. The main diagnoses were: 16 epithelial lesions (38.09%), 14 inflammatory lesions (31.70%), 10 melanocytic lesions (21,95%), 2 lymphoid lesions (4.87%). From the 28 cases that had a preoperative clinical hypothesis only 17 presented a histopathological confirmation of the diagnosis (60.71%). CONCLUSION: The most common caruncle lesions were epithelial tumors followed by chronic inflammation and melanocytic lesions. Although most of the lesions were benign, there was a great number of misdiagnose based on the clinical suspicious.