By American Academy of Ophthalmology, Robert H. Rosa Jr. MD
Part four provides fabrics in elements: half I, Ophthalmic Pathology; and half II, Intraocular Tumors: medical elements. half I makes use of a hierarchy that strikes from normal to precise to assist derive a differential analysis for a selected tissue. half II is a compilation of chosen scientific points of significance to the overall ophthalmologist. Following half II are the yankee Joint Committee on melanoma 2010 staging types for ocular and adnexal tumors.
Upon of completion of part four, readers may be capable to:
Describe a established method of knowing significant ocular stipulations in line with a hierarchical framework of topography, sickness approach, common analysis and differential diagnosis
Summarize the stairs in dealing with ocular specimens for pathologic examine, together with acquiring, dissecting, processing, and marking tissues
Identify these ophthalmic lesions that point out systemic illness and are very likely existence threatening
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Additional resources for 2014-2015 Basic and Clinical Science Course (BCSC): Section 4: Ophthalmic Pathology and Intraocular Tumors
Chevez-Barrios P. Frozen section diagnosis and indications in ophthalmic pathology. Arch Pathol Lab Med. 2005;129(12):1626-1634. D CHAPTER 5 Conjunctiva Topography The conjunctiva is a mucous membrane lining the posterior surface of the eyelids and the anterior surface of the globe as far as the limbus. It can be subdivided into palpebral, Jorniceal, bulbar, and caruncular sections. The conjunctiva consists of epithelium and un derlying stroma. The epithelium is nonkeratinizing stratified squamous, with goblet cells.
Previous communication with ophthalmic pathologist to discuss a. Logistics of the biopsy i. Possible adequacy check during the biopsy (intraocular tumors) ii . Fixative to be used iii. Fresh tissue for possible molecular diagnosis b. Specific cytology form to be filled out Flow Cytometry 1. Previous communication with ophthalmic pathologist to discuss a. Fresh tissue is critical. b. Adequate sample is essential. c. Geographic proximity to the laboratory Molecular Techniques and Electron Microscopy 1.
The color product of the chromogens generally used in ophthalmic pathology is brown or red in tissue sections, depending on the chromogen selected for use (Fig 4-2). Red chromogen is especially helpful in working with ocular pigmented tissues and melanomas, because it differs from the brown melanin pigment (see Fig 4-7). The precise cell or cells that display the specific antigen can be identified using these methods. Many antibodies are used routinely for diagnosis, treatment, and prognosis: • cytokeratins for lesions composed of epithelial cells (adenoma, carcinoma) • desmin, myoglobin, or actin for lesions with smooth muscle or skeletal muscle features (leiomyoma, rhabdomyosarcoma) • S-100 protein for lesions of neuroectodermal origin (schwannoma, neurofibroma, melanoma) • HMB-45 and Melan A for melanocytic lesions (nevus, melanoma) 33 34 • Ophth;lmic Patholpgy and lntraocular Tumors Table 4-1 Checklist for Requesting an Ophthalmic Pathologic Consultation Routine Specimens (cornea, conjunctiva, eyelid lesions) 1.
2014-2015 Basic and Clinical Science Course (BCSC): Section 4: Ophthalmic Pathology and Intraocular Tumors by American Academy of Ophthalmology, Robert H. Rosa Jr. MD