RESUMEN
PURPOSE: To evaluate the efficacy, recurrence rate, and long-term complications of topical mitomycin C (MMC) 0.02% for conjunctival-corneal intraepithelial neoplasia (CCIN). METHODS: A prospective, nonrandomized, noncontrolled study was conducted of patients with primary or recurrent CCIN treated with topical MMC 0.02%, four times per day, for 28 consecutive days. The main outcome measures were complete resolution of the neoplasia by slit-lamp examination and cytology 1 month after treatment, tumor recurrence, and long-term complications. RESULTS: Between June 1999 and September 2005, 23 patients were included. Eighteen had primary CCIN (group 1) and 5 had recurrent CCIN (group 2). The mean follow-up was 46 months in group 1 and 54 months in group 2. All patients were treated with MMC 0.02% for 28 consecutive days. Complete resolution of the lesion was achieved in all patients after 1 month of treatment. Recurrence occurred in 1 patient (4.3%) after 24 months of treatment. Four patients developed corneal erosion (17.4%), 2 of them with primary CCIN and 2 with recurrent CCIN. Corneal erosion occurred 4 to 24 months after treatment and was treated successfully. The probability for corneal erosions by the log-rank test was equal for both groups (p = 0.1705). CONCLUSIONS: The use of topical MMC 0.02% for 28 consecutive days to treat primary or recurrent CCIN was effective and showed a low recurrence rate. Corneal erosion occurred in 17.4% of cases and can occur as late as 24 months after treatment.
Asunto(s)
Antibióticos Antineoplásicos/administración & dosificación , Carcinoma in Situ/tratamiento farmacológico , Neoplasias de la Conjuntiva/tratamiento farmacológico , Enfermedades de la Córnea/tratamiento farmacológico , Mitomicina/administración & dosificación , Recurrencia Local de Neoplasia/tratamiento farmacológico , Adulto , Anciano , Anciano de 80 o más Años , Biopsia , Carcinoma in Situ/patología , Neoplasias de la Conjuntiva/patología , Enfermedades de la Córnea/patología , Relación Dosis-Respuesta a Droga , Neoplasias del Ojo/tratamiento farmacológico , Neoplasias del Ojo/patología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/patología , Soluciones Oftálmicas , Estudios Prospectivos , Factores de Tiempo , Resultado del TratamientoAsunto(s)
Humanos , Masculino , Persona de Mediana Edad , Carcinoma Hepatocelular/secundario , Neoplasias Hepáticas/patología , Neoplasias Orbitales/secundario , Biopsia , Carcinoma Hepatocelular/diagnóstico , Resultado Fatal , Inmunoquímica , Neoplasias Hepáticas/diagnóstico , Neoplasias Orbitales/diagnóstico , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND: Orbital idiopathic inflammation, lymphoid hyperplasia, and lymphoma may all present clinically in the same manner. Histopathology and especially immunohistochemistry play a major role in the differential diagnosis. The purpose of this study was to determine the immunophenotypic features of these lesions. METHODS: Fifty-five orbital lymphoid lesions were retrieved from the ophthalmic pathology registries at McGill University, Montreal, Canada, and the Federal University of São Paulo, São Paulo, Brazil. Formalin-fixed, paraffin-embedded, histopathologic sections were stained with hematoxylin and eosin and periodic acid-Schiff. The sections were also immunostained for B-cell (CD20) and T-cell (CD43) markers and for immunoglobulin light chains kappa and lambda. Two pathologists determined the histopathologic and immunohistochemical pattern of each lesion in a masked fashion. RESULTS: Of the 55 lesions, 11 (20%) were idiopathic chronic inflammations, 22 (40%) were lymphoid hyperplasias and 22 (40%) were lymphomas. Idiopathic inflammation displayed a predominance of T cells and all lesions expressed polyclonal light chains. Lymphoid hyperplasia displayed a mixture of B cells and T cells, with a slight predominance of the former and all lesions expressed polyclonal light chains. Lymphoma showed a striking predominance of B cells and all lesions expressed monoclonal light chains, usually kappa (63.7%). The differences in the mean percentages of B cells among the orbital lymphoid lesions (inflammation, 35%; hyperplasia, 65.9%; lymphoma, 87.3%) were statistically significant (p < 0.001). INTERPRETATION: Orbital lymphoid lesions can be differentiated based on the percentages of B cells and T cells and the monoclonal or polyclonal expression of immunoglobulin light chains.
Asunto(s)
Linfoma/patología , Neoplasias Orbitales/patología , Seudotumor Orbitario/patología , Seudolinfoma/patología , Adolescente , Adulto , Anciano , Antígenos CD20/metabolismo , Antígenos CD34/metabolismo , Linfocitos B/patología , Biomarcadores de Tumor/metabolismo , Femenino , Humanos , Cadenas kappa de Inmunoglobulina/metabolismo , Cadenas lambda de Inmunoglobulina/metabolismo , Inmunohistoquímica , Inmunofenotipificación , Linfoma/metabolismo , Masculino , Persona de Mediana Edad , Neoplasias Orbitales/metabolismo , Seudotumor Orbitario/metabolismo , Seudolinfoma/metabolismo , Linfocitos T/patologíaRESUMEN
Os autores apresentaram dois casos clinicamente distintos, com diagnóstico histopatológico de amiloidose corneana localizada, sem que padräo familiar e patologias oculares ou sistêmicas associadas pudessem ser identificadas. De acordo com a literatura, os autores fazem o diagnóstico de amiloidose corneana secundária, na qual a provável patologia causal näo foi identificada, mas näo descartam a possibilidade de amiloidose primária localizada da córnea, patologia esta extremamente rara