Difference between revisions of "Pterygium"
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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = Pterygium_-_high_mag.jpg | |||
| Width = | |||
| Caption = Pterygium. [[H&E stain]]. | |||
| Synonyms = surfer eye | |||
| Micro = hyaline material beneath epithelium, elastic fibres beneath the hyaline material, +/-inflammation, [[solar elastosis]], dilated [[blood vessels]] | |||
| Subtypes = | |||
| LMDDx = squamous dysplasia, [[squamous cell carcinoma]] | |||
| Stains = | |||
| IHC = | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Site = [[eye]] - more specifically ''conjunctiva'' | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = sun exposure | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = common | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = benign | |||
| Other = [[pinguecula]] considered early pterygium by some | |||
| ClinDDx = | |||
| Tx = excision | |||
}} | |||
'''Pterygium''' is a common benign pathology of the [[eye]]. It is also known as '''surfer eye'''. | |||
It is similar to [[pinguecula]] and Raizada ''et al.''<ref name=pmid1031388>{{Cite journal | last1 = Raizada | first1 = IN. | last2 = Bhatnagar | first2 = NK. | title = Pinguecula and pterygium (a histopathological study). | journal = Indian J Ophthalmol | volume = 24 | issue = 2 | pages = 16-8 | month = Jul | year = 1976 | doi = | PMID = 1031388 | URL = http://www.ijo.in/text.asp?2007/55/1/83/29517 }}</ref> suggest ''pinguecula'' is an early pterygium; however, this is disputed. | |||
==General== | |||
*Pronounced: "tuh-rij-ee-uhm".<ref>URL: [http://dictionary.reference.com/browse/pterygium http://dictionary.reference.com/browse/pterygium]. Accessed on: 20 October 2011</ref> | |||
*Conjunctiva lesion that covers part of the sclera. | |||
**[[Sclera]] = white part of the eye.<ref>URL: [http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002006/ http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002006/]. Accessed on: 20 October 2011.</ref> | |||
*Benign. | |||
*Due to ultraviolet light exposure, i.e. sunlight.<ref name=pmid2695353>{{Cite journal | last1 = Hill | first1 = JC. | last2 = Maske | first2 = R. | title = Pathogenesis of pterygium. | journal = Eye (Lond) | volume = 3 ( Pt 2) | issue = | pages = 218-26 | month = | year = 1989 | doi = 10.1038/eye.1989.31 | PMID = 2695353 | URL = http://www.nature.com/eye/journal/v3/n2/abs/eye198931a.html }}</ref> | |||
==Gross== | |||
*Medial aspect of eye - covers sclera (white part) and part of the iris (coloured part). | |||
===Image=== | |||
<gallery> | |||
Image:Pterygium (from Michigan Uni site, CC-BY).jpg |Pterygium. (WC/Jonathan Trobe) | |||
</gallery> | |||
==Microscopic== | |||
Features:<ref name=pmid2695353>{{Cite journal | last1 = Hill | first1 = JC. | last2 = Maske | first2 = R. | title = Pathogenesis of pterygium. | journal = Eye (Lond) | volume = 3 ( Pt 2) | issue = | pages = 218-26 | month = | year = 1989 | doi = 10.1038/eye.1989.31 | PMID = 2695353 | URL = http://www.nature.com/eye/journal/v3/n2/abs/eye198931a.html }}</ref> | |||
*Hyaline material beneath epithelium. | |||
*Elastic fibres beneath the hyaline material. | |||
*+/-Inflammation. | |||
*[[Solar elastosis]].<ref name=uic_edu>URL: [http://www.uic.edu/depts/mcpt/eyepath/specco4.htm http://www.uic.edu/depts/mcpt/eyepath/specco4.htm]. Accessed on: 25 October 2011.</ref> | |||
**Dense gray/light brown acellular material. | |||
*Dilated vessels.<ref name=uic_edu>URL: [http://www.uic.edu/depts/mcpt/eyepath/specco4.htm http://www.uic.edu/depts/mcpt/eyepath/specco4.htm]. Accessed on: 25 October 2011.</ref> | |||
Note: | |||
*Goblet cells within the squamous epithelium are expected; normal [[conjunctiva]] has goblet cells. | |||
DDx: | |||
*Squamous dysplasia. | |||
*[[Squamous cell carcinoma]].<ref name=pmid427069>{{Cite journal | last1 = Clear | first1 = AS. | last2 = Chirambo | first2 = MC. | last3 = Hutt | first3 = MS. | title = Solar keratosis, pterygium, and squamous cell carcinoma of the conjunctiva in Malawi. | journal = Br J Ophthalmol | volume = 63 | issue = 2 | pages = 102-9 | month = Feb | year = 1979 | doi = | PMID = 427069 | PMC = 1043407 }}</ref> | |||
===Images=== | |||
www: | |||
*[http://www.uic.edu/depts/mcpt/eyepath/specco4.htm Pterygium (uic.edu)]. | |||
<gallery> | |||
Image:Pterygium_-_intermed_mag.jpg | Pterygium - intermed. mag. (WC/Nephron) | |||
Image:Pterygium_-_high_mag.jpg | Pterygium - high mag. (WC/Nephron) | |||
</gallery> | |||
==Sign out== | |||
===Right eye=== | |||
<pre> | |||
Right Eye, Conjunctiva (Submitted as "Pterygium"), Excision: | |||
- Conjunctival mucosa with solar elastosis and dilated superficial blood vessels, compatible with pterygium. | |||
- NEGATIVE for dysplasia. | |||
</pre> | |||
====Inflammation present==== | |||
<pre> | |||
Right Eye, Conjunctiva (Submitted as "Left Pterygium"), Excision: | |||
- Conjunctival mucosa with solar elastosis, mild inflammation and dilated superficial blood | |||
vessels, compatible with pterygium. | |||
- NEGATIVE for dysplasia. | |||
</pre> | |||
====No solar elastosis==== | |||
<pre> | |||
Right Eye, Conjunctiva (Submitted as "Right Pterygium"), Excision: | |||
- Conjunctival mucosa with dilated superficial blood vessels and | |||
benign mild stromal changes. | |||
- NEGATIVE for dysplasia. | |||
</pre> | |||
====Block letters==== | |||
<pre> | |||
CONJUNCTIVA ("PTERYGIUM"), RIGHT, EXCISION: | |||
- CONJUNCTIVAL MUCOSA WITH STROMAL ACTINIC CHANGES -- CONSISTENT WITH PTERYGIUM. | |||
</pre> | |||
<pre> | |||
CONJUNCTIVA ("PTERYGIUM"), RIGHT, EXCISION: | |||
- CONJUNCTIVAL MUCOSA WITH STROMAL ACTINIC CHANGES -- CONSISTENT WITH PTERYGIUM. | |||
- NEGATIVE FOR DYSPLASIA. | |||
</pre> | |||
<pre> | |||
CONJUNCTIVA ("PTERYGIUM"), RIGHT EYE, EXCISION: | |||
- CONJUNCTIVAL MUCOSA WITH SOLAR ELASTOSIS AND DILATED SUPERFICIAL BLOOD VESSELS -- CONSISTENT WITH PTERYGIUM. | |||
- NEGATIVE FOR DYSPLASIA. | |||
</pre> | |||
===Left eye=== | |||
<pre> | |||
CONJUNCTIVA ("PTERYGIUM"), LEFT EYE, EXCISION: | |||
- CONJUNCTIVAL MUCOSA WITH SOLAR ELASTOSIS AND DILATED SUPERFICIAL BLOOD VESSELS -- CONSISTENT WITH PTERYGIUM. | |||
- NEGATIVE FOR DYSPLASIA. | |||
</pre> | |||
==See also== | |||
*[[Eye]]. | |||
*[[Eyelid]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Eye]] | |||
Latest revision as of 15:02, 9 June 2016
| Pterygium | |
|---|---|
| Diagnosis in short | |
 Pterygium. H&E stain. | |
|
| |
| Synonyms | surfer eye |
|
| |
| LM | hyaline material beneath epithelium, elastic fibres beneath the hyaline material, +/-inflammation, solar elastosis, dilated blood vessels |
| LM DDx | squamous dysplasia, squamous cell carcinoma |
| Site | eye - more specifically conjunctiva |
|
| |
| Clinical history | sun exposure |
| Prevalence | common |
| Prognosis | benign |
| Other | pinguecula considered early pterygium by some |
| Treatment | excision |
Pterygium is a common benign pathology of the eye. It is also known as surfer eye.
It is similar to pinguecula and Raizada et al.[1] suggest pinguecula is an early pterygium; however, this is disputed.
General
- Pronounced: "tuh-rij-ee-uhm".[2]
- Conjunctiva lesion that covers part of the sclera.
- Benign.
- Due to ultraviolet light exposure, i.e. sunlight.[4]
Gross
- Medial aspect of eye - covers sclera (white part) and part of the iris (coloured part).
Image
Pterygium. (WC/Jonathan Trobe)
.jpg)
Microscopic
Features:[4]
- Hyaline material beneath epithelium.
- Elastic fibres beneath the hyaline material.
- +/-Inflammation.
- Solar elastosis.[5]
- Dense gray/light brown acellular material.
- Dilated vessels.[5]
Note:
- Goblet cells within the squamous epithelium are expected; normal conjunctiva has goblet cells.
DDx:
- Squamous dysplasia.
- Squamous cell carcinoma.[6]
Images
www:
Pterygium - intermed. mag. (WC/Nephron)
Pterygium - high mag. (WC/Nephron)
Sign out
Right eye
Right Eye, Conjunctiva (Submitted as "Pterygium"), Excision: - Conjunctival mucosa with solar elastosis and dilated superficial blood vessels, compatible with pterygium. - NEGATIVE for dysplasia.
Inflammation present
Right Eye, Conjunctiva (Submitted as "Left Pterygium"), Excision: - Conjunctival mucosa with solar elastosis, mild inflammation and dilated superficial blood vessels, compatible with pterygium. - NEGATIVE for dysplasia.
No solar elastosis
Right Eye, Conjunctiva (Submitted as "Right Pterygium"), Excision: - Conjunctival mucosa with dilated superficial blood vessels and benign mild stromal changes. - NEGATIVE for dysplasia.
Block letters
CONJUNCTIVA ("PTERYGIUM"), RIGHT, EXCISION:
- CONJUNCTIVAL MUCOSA WITH STROMAL ACTINIC CHANGES -- CONSISTENT WITH PTERYGIUM.
CONJUNCTIVA ("PTERYGIUM"), RIGHT, EXCISION:
- CONJUNCTIVAL MUCOSA WITH STROMAL ACTINIC CHANGES -- CONSISTENT WITH PTERYGIUM.
- NEGATIVE FOR DYSPLASIA.
CONJUNCTIVA ("PTERYGIUM"), RIGHT EYE, EXCISION:
- CONJUNCTIVAL MUCOSA WITH SOLAR ELASTOSIS AND DILATED SUPERFICIAL BLOOD VESSELS -- CONSISTENT WITH PTERYGIUM.
- NEGATIVE FOR DYSPLASIA.
Left eye
CONJUNCTIVA ("PTERYGIUM"), LEFT EYE, EXCISION:
- CONJUNCTIVAL MUCOSA WITH SOLAR ELASTOSIS AND DILATED SUPERFICIAL BLOOD VESSELS -- CONSISTENT WITH PTERYGIUM.
- NEGATIVE FOR DYSPLASIA.
See also
References
- ↑ Raizada, IN.; Bhatnagar, NK. (Jul 1976). "Pinguecula and pterygium (a histopathological study).". Indian J Ophthalmol 24 (2): 16-8. PMID 1031388.
- ↑ URL: http://dictionary.reference.com/browse/pterygium. Accessed on: 20 October 2011
- ↑ URL: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002006/. Accessed on: 20 October 2011.
- ↑ 4.0 4.1 Hill, JC.; Maske, R. (1989). "Pathogenesis of pterygium.". Eye (Lond) 3 ( Pt 2): 218-26. doi:10.1038/eye.1989.31. PMID 2695353.
- ↑ 5.0 5.1 URL: http://www.uic.edu/depts/mcpt/eyepath/specco4.htm. Accessed on: 25 October 2011.
- ↑ Clear, AS.; Chirambo, MC.; Hutt, MS. (Feb 1979). "Solar keratosis, pterygium, and squamous cell carcinoma of the conjunctiva in Malawi.". Br J Ophthalmol 63 (2): 102-9. PMC 1043407. PMID 427069. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1043407/.