The role of cytology in the diagnosis of ophthalmic...
Transcript of The role of cytology in the diagnosis of ophthalmic...
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The role of cytology in the diagnosis of ophthalmic lesions of the eyelid, conjunctiva and cornea
Roberta Rubeša-Mihaljević,
Department of pathology
and cytology
Clinical Hospital Center, Rijeka
Croatia
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Cytology of accesible lesions in
ophthalmology
fast, simple, safe
when clinical examination is not enough to
establish the diagnosis
warrants early diagnosis
helps planning the extent of the surgical
procedure
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The external surface of eye includes: eyelid, lid
margin, conjunctiva and cornea
tarsal conjunctiva
bulbar conjunctiva
fornical conjunctiva
Conjunctiva
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Cytology of the conjunctiva
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Cornea
Cytology of the cornea
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Sampling techniques
-spatula
-cotton swab
-cytobrush
-hockey blade
Scrape Cytology
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-close cooperation
between the ophthalmologist and the cytopathologist
FNA
Impression cytology
-cellulose filter
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- 97 samples of patients treated at the Department of ophthalmology
- samples obtained from accesiblelesions of the conjunctiva, cornea, eyelid or lacrimal apparatus
Sampling
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Classifying of samples
- of 31 abnormal cytological findings 28 were confirmed histologically
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Inflammatory lesions
Acute inflammatory changes - aspiration of the vitreous body fluid
- the bacteria most commonly responsible for bacterial keratitis are
Streptococcus, Staphylococcus species and Enterobacteriaceae
- viruses - Herpes simplex, Zoster, Adenoviruses
- fungal keratits - due to trauma
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Chronic granulomatous
inflammatory changes
Inflammatory lesions
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Inflammatory lesions
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Premalignant lesions
cytology - abnormal keratinization with parakeratosis, dyskeratosis, atypical
squamous cells
histopathology - In situ carcinoma of the conjunctiva
- abnormalities ranging from mild to severe dysplasia or carcinoma in situ
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Malignant tumors
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Malignant tumors
Squamous cell carcinoma
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Malignant tumors
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Basocellular carcinoma
Malignant tumors
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Sebaceous gland carcinoma
A 78-year old patient presenting with a painless, enlarging mass in the eyelid
Malignant tumors
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Extranodal marginal zone lymphoma (MALT)
- the majority of ocular adnexal lymphomas are extranodal neoplasms
- 10-30% are secondary tumors in patients with disseminated lymphoma
- the most common are extranodular marginal zone lymphoma of mucosa-
associated lymphoid tissue (MALT) type, follicular lymphoma and diffuse large
B-cell lymphoma
Malignant tumors
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-a patient previously treated for conjunctival melanoma was
suspected for relapse
-cytology: cells expressing inflammatory changes and reparatory
changes, HMB-45-
-histopathology: granuloma pyogenicum
Malignant tumors
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Conclusion
- ocular surface lesions are easily accessible to the
application of cytology techniques, which are rapid,
non-invasive, easy to perform
- facilitates the clinical management of the patient and
the therapeutic decision
- the specific location of the ocular lesions requires a
close cooperation between the ophthalmologist and
cytologist
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Thank you for your attention!