Eye برای بزرگنمایی عکسها کلیک را روی ان نگه دارید..... Figure 45.1 Dermoid cyst of right upper eyelid Figure 45.2 Ruptured orbital dermoid cyst containing hair with foreign body reaction Figure 45.3 Eyelid Ectropion. The meibomian gland duct is also dilated (arrow) Figure 45.4 Chalazion of right upper eyelid Figure 45.5 Multiple foci of granulomatous inflammation with lipid drop-out spaces in chalazion Figure 45.6 Obstruction of outflow from the gland of Moll can lead to apocrine hidrocystoma Figure 45.7 Whole mount of sebaceous gland carcinoma compressing but not infiltrating the ocular globe. The tumor is sharply circumscribed and very cellular and has areas of necrosis Figure 45.8 Poorly differentiated sebaceous carcinoma Figure 45.9 Sebaceous carcinoma replacing the majority of the con- junctival epithelium Figure 45.10 Endocrine mucin-producing sweat gland carcinoma showing predominantly solid growth with small mucin-filled cystic spaces Figure 45.11 Expression of synaptophysin and other neuroendocrine markers is generally focal in endocrine mucin-producing sweat gland carcinoma Figure 45.12 MART1 immunohistochemistry highlights a melanocytic nevus associated with the meibomian gland Figure 45.13 Sturge-Weber Syndrome. The patient, a 42-year-old man, had had facial hemangioma all his life and was blind in the ipsilateral eye because of retinal degeneration, glaucoma, and cataract. Choroidal hemangioma was found in the enucleated eye, but clinical study failed to disclose evidence of an intracranial lesion. (Courtesy of the Veterans Administration Hospital, Hines, IL.) Figure 45.14 Xanthelasma of upper eyelids in a patient who had no systemic findings (arrows) Figure 45.15 Xanthelasma of Eyelid. Clusters of foamy macrophages are seen in the dermis in association with a few lymphocytes Figure 45.16 Bland histiocytoid metastatic lobular breast carcinoma involving eyelid and orbit Figure 45.17 Benign mixed tumor of lacrimal gland largely composed of so-called hyaline cells: A, low-power view showing encapsulated quality; B, high-power view showing a diffuse eosinophilic appearance of the cytoplasm; C, strong immunoreactivity for S-100 protein Figure 45.18 Diffuse large B cell lymphoma involving lacrimal gland and orbit Figure 45.19 Transitional cell papilloma of lacrimal sac with inverted growth pattern. This lesion later recurred as an invasive carcinoma Figure 45.20 A, Exophthalmos of approximately 10 months' duration in a 65-year-old woman who finally died of congestive heart failure. B, At autopsy, extraocular muscles were found to be massively thickened Figure 45.21 Polyangiitis with granulomatosis involving orbit: A, multiple confluent granulomas; B, vasculitis with thrombosis Figure 45.22 Large intraorbital mass in a case of Rosai-Dorfman disease Figure 45.23 Increased numbers of IgG4-positive cells in an inflammatory process involving the lacrimal gland and orbit. The ratio of IgG4/IgG-positive cells was over 60% in this case, and serum IgG4 levels were also greatly elevated Figure 45.24 Inflammatory Pseudotumor of Orbit. Lymphocytes, plasma cells and spindle cells of fibroblastic/myofibroblastic appearance permeate the adipose tissue of the orbit Figure 45.25 Solitary Fibrous Tumor of Orbit. The alternation of hypercellular and hypocellular areas is characteristic. The collagen has a keloid-type quality. This tumor was strongly immunoreactive for CD34 Figure 45.26 A, Alveolar soft part sarcoma of orbit. B, This degree of desmin immunoreactivity is unusual, but it constitutes strong evidence for muscle differentiation Figure 45.27 A well-circumscribed cavernous hemangioma of the orbit in an adult Figure 45.28 Glioma that has produced massive enlargement of the orbital segment of the optic nerve. The tumor has completely effaced characteristic architectural features of the nerve and its meninges Figure 45.29 Pilocytic astrocytoma with prominent Rosenthal fibers (arrows) Figure 45.30 Meningioma of Optic Nerve. The meninges are greatly thickened, and the optic nerve reveals severe compression and atrophy (arrows) Figure 45.31 CT scan showing perioptic meningioma of left orbit (arrow) Figure 45.32 Meningioma of Orbit. The tumor has a typical meningo- thelial appearance Figure 45.33 A, Malignant lymphoid proliferation of conjunctiva composed of small tumor cells with prominent plasmacytoid features. B, There is strong immunoreactivity for kappa light chain Figure 45.34 Small Lymphocytic Proliferation of Orbit. A, Low-power appearance showing a monotonous infiltrate of small lymphoid cells. B, PAS stain in another case, showing PAS-positive intranuclear inclusions composed of inspissated immunoglobulin (Dutcher bodies). The occurrence of these formations favors a neoplastic nature for the proliferation Figure 45.35 So-Called Granulocytic Sarcoma of Orbit. This represents a localized focus of acute myelocytic leukemia Figure 45.36 Limbal dermoid in a child Figure 45.37 Limbal dermolipoma with both hair and adipose tissue in the stroma Figure 45.38 Pterygium that has grown over the pupillary axis and has interfered with vision Figure 45.39 Pterygium tissue extends over a cornea Figure 45.40 Papilloma of bulbar conjunctiva containing pale gray goblet cells (arrow) Figure 45.41 CIS of conjunctiva and cornea Figure 45.42 Conjunctival intraepithelial neoplasia typically shows sharp peripheral borders with nondysplastic epithelium Figure 45.43 Squamous cell carcinoma of conjunctiva growing extensively inside the orbit and compressing the ocular globe Figure 45.44 Lightly pigmented conjunctival lesion that proved to be a benign nevus Figure 45.45 Conjunctival nevus with many associated cystic epithelial inclusions. Small round cells about large cysts are not inflammatory cells but nevus cells Figure 45.46 An inflamed "juvenile" conjunctival compound nevus in a 10-year-old boy. MITF immunostains highlight melanocytic cells in the conjunctival base and surrounding invaginating epithelial cysts and nests, while deeper region show dense chronic inflammation Figure 45.47 Primary acquired melanosis (PAM) with moderate atypia showing lentiginous proliferation of atypical melanocytes in the conjunctival base and some pagetoid spread Figure 45.48 Malignant melanoma arising in a conjunctival nevus, with HMB45 negative nevoid nests in the left of the specimen, and more diffuse HMB45-positive cells on the right Figure 45.49 Conjunctival melanoma cells corresponding to the HMB45- positive region in Fig. 45.48 Figure 45.50 Melanoma of iris that had been observed over a period of 10 years, during which time it became progressively larger and encroached on the pupil. Iridectomy revealed it to be of spindle A cell type. The tumor recurred and necessitated enucleation for secondary glaucoma 15 years after iridectomy. (Courtesy of Dr ME Nugent, Bismarck, ND.) Figure 45.51 Malignant melanoma of choroid that, by erupting through Bruch's membrane, has formed a mushroom-shaped subretinal mass Figure 45.52 Melanomas of iris are frequently visible through the cornea. Hence, their duration and rate of growth are often known by the patient or family long before other subjective or objective manifestations appear Figure 45.53 A choroidal melanoma comprised predominantly of spindle A cells Figure 45.54 A choroidal melanoma comprised predominantly of spindle B cells Figure 45.55 A choroidal melanoma comprised predominantly of epi- thelioid cells Figure 45.56 Uveal melanoma cells extending through a scleral canal Figure 45.57 Bilateral retinoblastoma showing a white mass consisting of detached retina and neoplastic tissue immediately behind the lens in each eye Figure 45.58 Prominent white reflex attributed to retinoblastoma present in the dilated pupil of the left eye Figure 45.59 Retinoblastoma presenting as a highly cellular neoplasm with scant stroma. The tumor tends to outgrow its blood supply, and irregular areas of necrosis are commonly observed Figure 45.60 Retinoblastoma with a collar of viable cells about nutrient vessels with necrotic cells further away. Calcification is seen on the left Figure 45.61 Retinoblastoma with a few Flexner-Wintersteiner and Homer Wright rosettes Figure 45.62 Retinocytoma with small bland cells, fleurettes, and a very low Ki67 proliferation index Figure 45.63 Anaplastic retinoblastoma with highly pleomorphic cells showing angular molding and wrapping as well as prominent nucleoli. This lesion was amplified at the NMYC locus Figure 45.64 Electron micrograph of retinoblastoma. A portion of the center of a rudimentary Flexner-Wintersteiner rosette illustrating a bulbous apical microtubule-containing cytoplasmic process and numerous cell junctions. (Courtesy of Dr Robert A Erlandson, Memorial Sloan Kettering Cancer Center.) Figure 45.65 Retinoblastomas exhibit a tendency to spread out of the globe by way of the optic nerve (arrows). It is therefore of utmost importance for the surgical pathologist to determine whether such optic nerve extension has occurred and, if it has, to what extent Figure 45.66 Retinoblastoma invades from the subretinal space at the bottom of the image into the overlying choroid (arrows) Figure 45.67 Endophytic retinoblastoma on the right with scattered white vitreous seeds (arrows) behind the lens, which appears yellow Figure 45.68 Retinoblastoma cells extend under the retinal pigment epithelium but do not invade through Bruch's membrane into the overlying choroid (arrow) Figure 45.69 Fuchs adenoma are benign, generally incidental lesions comprised of nonpigmented ciliary epithelial cells and amorphous, hyaline material Figure 45.70 Ciliary body medulloepithelioma (non-teratoid) with primitive neuroectodermal cells lining well-defined surfaces Figure 45.71 This very large hemangioblastoma grew within the eye over several decades. The pale, vacuolated neoplastic cells are interspersed with proliferating vessels. Secondary bone formation is present in the left side of the image Figure 45.72 A "reactive" retinal astrocytic tumor which grew as a relatively discrete lesion over approximately 1 year. PAS stains highlight the prominent vessels between solid proliferations of spindled glia
