ABSTRACT
PURPOSE: To evaluate immunophenotypic profiles of infiltrating cells in surgically excised tissues of chalazion and pyogenic granuloma associated with chalazion. METHODS: Eighty-two surgical specimens from 74 consecutive patients newly diagnosed with chalazion or chalazion-associated pyogenic granuloma at Tokyo Medical University Hospital between 2016 and 2022 were studied. Sixty specimens were chalazion lesions and 22 specimens were pyogenic granuloma lesions (from 15 men and 7 women, mean age 36.6 ± 14.4 years). All patients were immunocompetent Asian Japanese adults. Specimens were analyzed by immunohistochemistry and flow cytometry. Flow cytometry was performed using the following antibodies: CD3, CD4, CD8, CD11b, CD11c, CD16, CD19, CD20, CD23, CD25, CD34, CD44, CD56, CD69, and CD138. RESULTS: In flow cytometric analysis, the proportion of cells expressing the T cell marker CD3 was significantly higher compared with other immune cells expressing specific markers (p < 0.0001), and the proportion of CD4-positive T cells was significantly higher than that of CD8-positive T cells (p < 0.0001), in both chalazion and pyogenic granuloma specimens. The chalazion and pyogenic granuloma lesions shared similar immunophenotypic profile characterized by predominant T cell infiltration, and CD4 T cells dominating over CD8 cells. The pattern of expression of CD4 and CD8 in the specimens was confirmed by immunohistochemistry. CONCLUSION: The present study demonstrates immunophenotypic features of chalazion and chalazion-associated pyogenic granuloma. Although various inflammatory cells are involved in the pathology of chalazion and pyogenic granuloma, a significantly higher proportion of CD4-positive T cells may be closely related to the pathological mechanisms of both lesions.
Subject(s)
Chalazion , Granuloma, Pyogenic , Male , Adult , Humans , Female , Young Adult , Middle Aged , Chalazion/metabolism , Granuloma, Pyogenic/diagnosis , Granuloma, Pyogenic/metabolism , Granuloma, Pyogenic/pathology , Immunophenotyping , CD4-Positive T-Lymphocytes/metabolism , CD4-Positive T-Lymphocytes/pathology , CD8-Positive T-Lymphocytes/metabolism , CD8-Positive T-Lymphocytes/pathology , Flow CytometryABSTRACT
PURPOSE: The use of immunomodulatory therapy in the setting of coexistence of uveitis and coronavirus disease (COVID-19) remains controversial. We report a case of COVID-19 during systemic steroid therapy for Vogt-Koyanagi-Harada disease (VKH). CASE REPORT: A 43-year-old female was diagnosed with VKH and started on steroid pulse therapy (1,000 mg/day) followed by high-dose oral corticosteroids. Two weeks after discharge from the hospital, she was readmitted to the intensive care unit with severe acute respiratory syndrome due to SARS-CoV-2 infection confirmed by PCR test, and fortunately both VKH and COVID-19-induced respiratory disease improved. CONCLUSION: Given the absence of international agreement on how to manage COVID-19 patients with steroid-dependent VKH, existing clinical guidelines should be reviewed thoroughly to formulate useful strategies for managing VKH patients on steroid treatment who contract COVID-19. Furthermore, the outcomes of patients with steroid-dependent autoimmune uveitis including VKH who develop COVID-19 should be analyzed.
Subject(s)
COVID-19 , Uveitis , Uveomeningoencephalitic Syndrome , Female , Humans , Adult , Uveomeningoencephalitic Syndrome/complications , Uveomeningoencephalitic Syndrome/diagnosis , Uveomeningoencephalitic Syndrome/drug therapy , SARS-CoV-2 , Uveitis/diagnosis , Uveitis/drug therapy , Steroids/therapeutic useSubject(s)
Central Nervous System Neoplasms , Lymphoma, Non-Hodgkin , Lymphoma , Retinal Neoplasms , Humans , Retinal Neoplasms/diagnosis , Retinal Neoplasms/pathology , Vitreous Body/pathology , Central Nervous System Neoplasms/diagnosis , Central Nervous System Neoplasms/etiology , Central Nervous System Neoplasms/pathology , Lymphoma/pathology , Lymphoma, Non-Hodgkin/pathology , Central Nervous System/pathologyABSTRACT
PURPOSE: T-Lymphoblastic lymphoma (T-LBL) is a rare malignant tumor originated from precursor T-lymphocytes that differentiate to T lymphocytes. We report a rare case of T-LBL presenting with conjunctival mass as the first sign. OBSERVATIONS: A 61-year-old man presented with a right salmon colored conjunctival mass. A biopsy was performed, and histopathologic examination showed dense lymphocyte proliferation in subepithelial substantia propria. Immunohistochemical staining was positive for CD7, CD10, and TdT; and negative for CD20. CD3 was negative in most parts PET-CT revealed abnormal uptake in the left cervix, anterior mediastinum, abdominal aortic lymph nodes, and multiple bones. From the above findings, stage IVA T-LBL was diagnosed. The patient received hyper CVAD therapy (cyclophosphamide + doxorubicin + vincristine + dexamethasone) and HD-MA therapy (high-dose methotrexate + cytarabine). Subsequently, an unrelated bone marrow transplant was performed. CONCLUSIONS AND IMPORTANCE: This case demonstrates the importance of considering rare lymphomas such as T-LBL in the differential diagnosis of ocular adnexal lymphoid neoplasms.
