Depósitos de cálcio na córnea: estudo histopatológico / Calcium deposits in the cornea: histopathological study

Resumo Objetivo: Estudar, através do exame histopatológico, os depósitos de cálcio na córnea e suas diferentes formas de apresentação. Metodos: Estudo observacional, transversal, retrospectivo e descritivo de botões corneanos provenientes de ceratoplastia penetrante no período de 2006 a 2015. Coloração de rotina foi realizada com Hematoxilina-eosina, tendo sido realizadas em alguns casos as colorações adicionais: Masson, PAS (Periodic Acid of Schiff reaction) e reticulina. Os tecidos foram examinados com microscópio óptico pelos autores. Selecionamos apenas os casos em que foram identificados depósitos de cálcio no exame histopatológico. Após selecionados os casos, foi realizada revisão de prontuários em busca de informações sobre sexo, idade e etiologia do transplante. Resultados: Foram, então, incluídos 12 casos. As diferentes formas de apresentação dos depósitos de cálcio corneanos encontradas no exame histopatológico foram grânulos, placas e formações ovaladas ou suas associações. A principal forma de depósito foram os grânulos isolados ou associados em 9 (75%) casos, seguido pelas placas isoladas ou associadas em 8 (66,66% casos). A associação mais frequente encontrada foi de grânulos + placa em 5 (41,66%) casos , seguida por grânulos + formações ovaladas em 2 (16,66%) casos. A partir dos achados no exame histopatológico, foi proposta uma classificação e uma possível evolução dos depósitos de cálcio corneanos. Conclusão: Através do exame histopatológico, demonstramos as diferentes formas de apresentação dos depósitos de cálcio na córnea e, para eles, sugerimos uma possível evolução. Formação ovaladas foram descritas como uma nova forma de apresentação desses depósitos, que permanecem, porém, necessitando de uma melhor compreensão.

Abstract Objective: To study, through histopathological examination, calcium deposits in the cornea and its different presentation forms. Methods: Observational, transversal, retrospective and descriptive study of corneal buttons from penetrating keratoplasty from 2006 to 2015. Routine staining was performed with Hematoxylin-eosin, and in some cases additional staining was performed: Masson, PAS (Periodic Acid Of Schiff reaction) and reticulin. The tissues were examined with an optical microscope by the authors. We selected only the cases in which calcium deposits were identified in the histopathological examination. After the cases were selected, a chart review was carried out looking for information about sex, age and transplantation etiology. Results: Twelve cases were included. The different forms of corneal calcium deposits presentation found in the histopathological examination were granules, plaques and oval formations or their associations. The main form of deposition were isolated or associated granules in 9 (75%) cases, followed by isolated or associated plaques in 8 (66.66% cases). The most frequent association was granule + plaque in 5 (41.66%) cases, followed by granules + oval formations in 2 (16.66%) cases. From the findings in the histopathological examination, a classification and a possible evolution of the corneal calcium deposits was proposed. Conclusion: Through histopathological examination we demonstrate the different forms of calcium deposits presentation in the cornea and propose a possible evolution for them. Oval formations were described as a new presentation form for these deposits, which remain demanding a better understanding.

Haga su diagnóstico / Do your diagnostic

Presentamos el caso de un niño con numerosas placas tumorales discrómicas bien definidas, algunas atróficas, otras levantadas, cubiertas por formaciones escamo-costrosas, indoloras, localizadas en extremidad inferior derecha, de curso lentamente progresivo. No se encuentran otros hallazgos clínicos acompañantes de importancia. El diagnóstico de certeza se efectúo mediante estudio de imagen e histopatológico; el tratamiento consistió en extirpación quirúrgica a intervalos irregulares.

An eleven-year old child with multiple depressed and raised skin pigmented tumors and plaques, with adherent desquamation and crusts on their skin suface was located in his right lower extremity. There are not any other clinical manifestation of interest. Diagnostic approach was based on radiological and pathology examinations. Surgical treatment was the suitable option.

Haga su diagnóstico / Do your diagnostic

Presentamos el caso de un niño con numerosas placas tumorales discrómicas bien definidas, algunas atróficas, otras levantadas, cubiertas por formaciones escamo-costrosas, indoloras, localizadas en extremidad inferior derecha, de curso lentamente progresivo. No se encuentran otros hallazgos clínicos acompañantes de importancia. El diagnóstico de certeza se efectúo mediante estudio de imagen e histopatológico; el tratamiento consistió en extirpación quirúrgica a intervalos irregulares.(AU)

An eleven-year old child with multiple depressed and raised skin pigmented tumors and plaques, with adherent desquamation and crusts on their skin suface was located in his right lower extremity. There are not any other clinical manifestation of interest. Diagnostic approach was based on radiological and pathology examinations. Surgical treatment was the suitable option.(AU)