Lecture 41 - Ophthalmic Pathology Flashcards
Sebaceous glands are more numerous in the ______ (upper or lower?) eyelid. So what does this mean for the prevalence of Sebaceous cell carcinoma in the eyelids?
Upper
This means Sebaceous cell carcinoma is more prevalent in the upper eyelid.
______ cell carcinoma is the most common primary tumor of the Eye.
Basal
Sebaceous cell carcinoma (aka Meibomian gland carcinoma) most often affect ______ (old or young?) patients. It often presents with loss of ______, though it may appear as a nodule under or on the edge of the eyelid. It is highly ______.
Old
Eyelashes
Malignant
Stye (aka Hordeolum) may appear red and like early Sebaceous cell carcinoma, but what can differentiate it?
It is most commonly caused by _____ ______.
Stye will be painful, as it is an infection with inflammation; Sebaceous cell carcinoma will not be painful.
Staph aureus
________ is a hard, painless (unlike Stye) lump under the eyelid. It is caused by ______ inflammation of a sebaceous gland –> keep in mind this is NOT infection. Sebum extravasates into the ECF.
Chalazion
Granulommatous inflammation
Chlamydia trachomatis can cause Trachoma in newborns, which is among the leading causes of ________ in developing countries (so look for immigrants in question stem). It is an infection of the _______, which will have a cobblestone appearance due to hyperplasia and underlying lymphoid ______.
Blindness
Conjunctiva
Lymphoid follicels
Both Pinguecula and Pterygium are membranous growths of the ______ conjunctiva, but one stops at the scleral-corneal junction. Which one?
These form from _____ exposure.
Bulbar (the part on the eyeball - keep in mind the paplibrar is on the underside of the eyelid)
Pinguecula stops at the scleral-corneal junction (does not invade the cornea)
UV exposure
Conjunctival Papiloma has characteristic pin-point redness, and it is associated with HPV ___ and ___ (the ____ risk strains).
HPV 6 and 11 (low risk)
______ _______ are typical manifestations of the healing process in the conjunctiva, so look for patients with hx of trauma, surgery, or infection in the eye.
Pyogenic Granulomas
How is Conjunctival Nevus differentiated from Melanoma?
Manipulate the conjunctiva overlying the sclera –> if the spot moves, it’s a Nevus. Melnoma penetrates into the sclera and will not move.
Conjunctiva-Squamous cell Carcinoma most often occurs in ________ patients (e.g. HIV+, transplant, etc.), and it is also associated with UV radiation or infection with HPV ___ and ___ (High risk strains). These are _____ (fast or slow?) growing, so look for a patient to say it wasn’t there a few months ago.
Histologically, these will have characteristic _______ pearls and _______ bridges.
Immunocompromised patients
HPV 16 and 18
Fast growing
Keratin Pearls
Intercellular bridges
______ ______ is an accumulation of lipids in the limbus (scleral-corneal junction).
Arcus Senilis
Kayser-Fleischer ring is the formation of a golden-brown ring at the limbus due to accumulation of _______ (Wilson’s disease) –> it deposits in Descemet’s membrane (endothelial lining under the corneal stromal layer).
Copper
The most common pathogens of Corneal Fungal infections are ______ and ______.
Asergillus and Candida
The Neurosensory Retina is a derivative of the ______, while the Rentinal Pigmented Epithelium (RPE) is a derivative of the Primary ______ vessel.
Diencephalon
Primary Optic Vessel
The normal Macula of the eye is a cup-shaped spot in the retina adjacent to the Optic disc. It contains ONLY ______ (rods or cones?).
Cones (color vision and high res)
Age related Macular Degeneraton occurs from lipid accumulation between the ______ and ______. These accumulations are called Drusen.
Where will the vision loss be in Macular Degeneration?
What is the difference between Dry and Wet Macular degen?
RPE and Choroid
Centrally
Dry –> Drusen
Wet –> neovascularization of Drusen from Choroid, leading to hemorrhage.
Retinoblastoma arises from a loss-of-function defect in Rb (tumor suppressor gene) on chromosome ______q14.
If it is congenital, patients can develop soft tissue and ______ malignancies later in life, so they require life-long follow-up. Also look for presencce of Rb in ______ gland.
________ seen on imaging are pathognomonic of Rb.
13q14
Soft tissue and Bone
Pineal gland
Calcifications
Malignant Melanoma is the most common Primary malignancy of the eye in Caucasian ______ (adults or children?). It occurs in the Uveal tract, most commonly in the ______. There are 2 types: ______ or ______ (though can be a combo). Which is most common?
Prognosis is poor when the tumor arises from the ______ body or _____.
Bc there aren’t any lymphatics in the eye, spread is hematogenous, and most commonly metastasizes to the ______.
Caucasian Adults
Choroid
Spindle
Epithelial
Spindle is most common
Cilliary body or Choroid
Liver
Most common Malignancies of the eye are Mets. They frequently arise in the Uveal tract, which consists of the _____ body, _____, and _____. Mets from breast, lung, and prostate are common.
Cilliary body, Iris, and Choroid
