RESUMO
PURPOSE: To investigate the utility of corneal biopsy in the evaluation of infectious keratitis; to compare results of culture and histopathologic examination of the same specimens; to investigate potential factors related to positive biopsy results. DESIGN: Retrospective, observational case series. METHODS: We reviewed medical records for all patients who underwent corneal biopsy because of infectious keratitis at the Jules Stein Eye Institute from June 1989 through June 2009. In general, biopsy specimens were both cultured and examined histopathologically. Lesion size, lesion progression, and interval from presentation to biopsy were analyzed as possible predictors of positive biopsies. RESULTS: Organisms were identified in 20 of 48 (42%) consecutive biopsies (positive cultures in 9 of 47 cases [19%]; positive histopathologic examination in 19 of 47 cases [40%]). Culture and histopathologic results were concordant in 30 of 46 biopsies (65%) for which both techniques were performed; 10 of the 16 discordant cases were culture-negative/histopathology-positive, while the remaining 6 had positive but discordant results for the 2 techniques (cultures all showed bacteria; histopathologic examination showed fungi or cysts consistent with Acanthamoeba sp.). Corneal biopsy revealed microorganisms in 12 of 27 patients (44%) with negative cultures of corneal scrapings obtained at presentation. None of the potential risk factors was statistically associated with positive biopsies. CONCLUSIONS: Corneal biopsy can be useful for identifying the cause of infectious keratitis in selected cases. Culture and histopathologic examination can provide complementary information, but discordant results may occur. Acanthamoebic and fungal infections are more likely to be identified by histopathologic examination.
Assuntos
Córnea/microbiologia , Córnea/patologia , Úlcera da Córnea/microbiologia , Úlcera da Córnea/patologia , Infecções Oculares Bacterianas , Infecções Oculares Fúngicas , Adulto , Idoso , Idoso de 80 Anos ou mais , Bactérias/isolamento & purificação , Técnicas Bacteriológicas , Biópsia , Infecções Oculares Bacterianas/microbiologia , Infecções Oculares Bacterianas/patologia , Infecções Oculares Fúngicas/microbiologia , Infecções Oculares Fúngicas/patologia , Feminino , Fungos/isolamento & purificação , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de RiscoRESUMO
Conjunctival papillomas are some of the most common tumors of the conjunctiva and are well-described in ophthalmology textbooks. However, they have not be well-recognized by the dermatologic community. These lesions may be encountered by the dermatologist during a full skin examination or they may be the presenting concern of a patient.
Assuntos
Neoplasias da Túnica Conjuntiva/patologia , Recidiva Local de Neoplasia/patologia , Papiloma/patologia , Neoplasias da Túnica Conjuntiva/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Papiloma/cirurgiaAssuntos
Sobrancelhas , Remoção de Cabelo/efeitos adversos , Verrugas/etiologia , Adjuvantes Imunológicos/uso terapêutico , Adulto , Aminoquinolinas/uso terapêutico , Criocirurgia , Feminino , Remoção de Cabelo/métodos , Humanos , Imiquimode , Verrugas/tratamento farmacológico , Verrugas/cirurgia , Adulto JovemRESUMO
A 67-year-old African-American woman presented with an enlarging darkly pigmented plaque on her scalp. Histopathologic examination revealed a basal cell carcinoma juxtaposed to a blue nevus. Interestingly, the most common types of cutaneous collision tumors include melanocytic nevus and basal cell carcinoma. Whether these combinations are simply because of chance or may have a pathophysiologic mechanism is contentious. This is the first documented case of a basal cell carcinoma co-existing alone with a blue nevus.
