mata & ocular adnexa ( bahan kuliah kedokteran
TRANSCRIPT
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BAGIAN PATOLOGI ANATOMIBAGIAN PATOLOGI ANATOMIFAKULTAS KEDOKTERANFAKULTAS KEDOKTERAN
USU – MEDANUSU – MEDAN20072007
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NORMAL ANATOMYNORMAL ANATOMY
PalpebraePalpebraeConjunctivaConjunctivaCorneaCorneaLensLensUvea tractUvea tractRetinaRetinaVitreous humorVitreous humorNerveNerveGlandGlandMuscleMuscleBlood vesselsBlood vessels
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NORMAL ANATOMYNORMAL ANATOMY
A - A - Vitreous humorVitreous humor
B - B - LensLens
C - C - CorneaCornea
D - D - PupilPupil
E - E - IrisIris
F - F - ScleraSclera
G - G - Optic NerveOptic Nerve
H - H - RetinaRetina
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CHOROIDCHOROID
CHOROID = MIDDLE CHOROID = MIDDLE LAYER EYE LAYER EYE
CONTAINS :CONTAINS :• BLOOD VESSELS &BLOOD VESSELS &• CONNECTIVE TISSUE CONNECTIVE TISSUE
• SUPPLIES NUTRIENTS SUPPLIES NUTRIENTS TO INNER PORTION OF TO INNER PORTION OF EYEEYE
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CILIARY BODY CILIARY BODY CILIARY BODYCILIARY BODY = ring of = ring of
tissue tissue encircles the lens. encircles the lens.
Contains : Contains : • smooth muscle fibers smooth muscle fibers
(ciliary muscles)(ciliary muscles)
• control the shape of the control the shape of the lens. lens.
Posterior surface lens Posterior surface lens (CILIARY PROCESSES)(CILIARY PROCESSES)
Contain : capillaries Contain : capillaries
• Secrete fluid (vitreous Secrete fluid (vitreous humor) humor) into the anterior into the anterior segment of the eyeball. segment of the eyeball.
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LACRIMAL SYSTEMLACRIMAL SYSTEM
LARGELY : SEROUS TYPE
MINOR MUCINOUS
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DISORDER OF EYEDISORDER OF EYE
MICRO ORGANISMS *MICRO ORGANISMS * ANTIGEN *ANTIGEN * TOXIC CHEMICAL *TOXIC CHEMICAL * SOLAR RADIATION *SOLAR RADIATION * SYSTEMIC DISEASE *SYSTEMIC DISEASE *
* * BLINDNESS BLINDNESS
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CONGENITAL ANOMALICONGENITAL ANOMALI
RARELY : RARELY : - ANOPTHTHALMOS- ANOPTHTHALMOS
- EYE’S (-)- EYE’S (-)- MICROPHTHALMOS- MICROPHTHALMOS
- MEDIAN EYE- MEDIAN EYE- HYPOPLASIA EYE’S- HYPOPLASIA EYE’S- COLOBOMA- COLOBOMA- CONGENITAL CATARACTS- CONGENITAL CATARACTS
- COLOR BLIND- COLOR BLIND
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COLOBOMACOLOBOMA ((Defect in iris)Defect in iris)
Appear : black notch Appear : black notch pupil : irregular (shape) pupil : irregular (shape) May be associated with :May be associated with :
• Hereditary conditionsHereditary conditions• Trauma to the eye, or Trauma to the eye, or • Eye surgeryEye surgery
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CONGENITAL CATARACTSCONGENITAL CATARACTS The number of people born with cataracts is low. The number of people born with cataracts is low.
Possible causes :Possible causes :• GalactosemiaGalactosemia • Chondrodysplasia syndrome Chondrodysplasia syndrome • Congenital Congenital rubellarubella syndrome syndrome • Down syndromeDown syndrome (trisomy 21) (trisomy 21) • Pierre-Robin syndrome Pierre-Robin syndrome • Familial congenital cataracts Familial congenital cataracts • Hallerman-Streiff syndrome Hallerman-Streiff syndrome • Lowe syndrome Lowe syndrome • TrisomyTrisomy 13 13 • Conradi syndrome Conradi syndrome • EctodermalEctodermal dysplasiadysplasia syndrome syndrome • Marinesco-Sjogren syndrome Marinesco-Sjogren syndrome
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CONGENITAL CATARACTS CONGENITAL CATARACTS
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PIGMENTATIONPIGMENTATION
EXOGENEXOGEN ENDOGENENDOGEN
ALBUMIN ALBUMIN MELANOSIS MELANOSIS
MELANINMELANIN
HEMOSIDERINE HEMOSIDERINE
I.O.HI.O.H
IRONIRONCOPPER COPPER SILVERSILVER
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PIGMENTATIONPIGMENTATION
KAYSER - FLEISCHER RINGKAYSER - FLEISCHER RING WILSON’S DISEASE (HEPATOLENTIWILSON’S DISEASE (HEPATOLENTI CULAR DEGENERATION)CULAR DEGENERATION)
DEPIGMENTATIONDEPIGMENTATION
VITILIGOVITILIGO
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PHYSICAL & CHEMICAL INJURIESPHYSICAL & CHEMICAL INJURIES
TRAUMA : ECCHYMOSISTRAUMA : ECCHYMOSIS SUP.FICIAL :SUP.FICIAL :
• CONTACT LENSCONTACT LENS• FOREIGN BODIESFOREIGN BODIES• ULTRA VIOLETULTRA VIOLET
CAUSTIC CHEMICALCAUSTIC CHEMICAL BLUNT TRAUMA BLUNT TRAUMA FRACTURE OF BONE FRACTURE OF BONE
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SKIN APPENDAGES OF EYELIDSSKIN APPENDAGES OF EYELIDS
1.1. SEBACEOUS GLANDS SEBACEOUS GLANDS (ZEIS & MEIBOMIAN)(ZEIS & MEIBOMIAN)
2.2. APOCRINE GLANDS APOCRINE GLANDS (MOLL)(MOLL)
3.3. ECCRINE SWEAT GLANDSECCRINE SWEAT GLANDS
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MOLUSCUM CONTANGIOSUMMOLUSCUM CONTANGIOSUM
VIRAL INFECT VIRAL INFECT WART LIKE WART LIKE CENTRAL UMBILICAL CENTRAL UMBILICAL KERATIN KERATIN
CYSTIC LESSIONCYSTIC LESSION SUDORIFERASUDORIFERA SEBACEASEBACEA MEIBOMIANMEIBOMIAN DERMOIDDERMOID
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HORDEOLUMHORDEOLUM( = STYE )( = STYE )
ZEIS GLAND (SEBACEOUS GLANDS)ZEIS GLAND (SEBACEOUS GLANDS) EXTERNAL HORDEOLUMEXTERNAL HORDEOLUM
MEIBOMIAN GLANDS MEIBOMIAN GLANDS INTERNAL INTERNAL HORDEOLUMHORDEOLUM
FOLICLE FOLICLE INFECTION STAPHYLLOCOCUS INFECTION STAPHYLLOCOCUS
CELLULITISCELLULITIS
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HORDEOLUMHORDEOLUM
EXTERNAL
INTERNAL
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CHALAZIONCHALAZION(MEIBOMIAN GLAND LIPOGRANULOMA)(MEIBOMIAN GLAND LIPOGRANULOMA)
A PAINLESS GRANULOMA A PAINLESS GRANULOMA OF THE MEIBOMIAN OF THE MEIBOMIAN GLANDS GLANDS
MEIBOMIAN GLAND MEIBOMIAN GLAND OCCLUTIONOCCLUTION
CHRONIC CHRONIC GRANULATIONGRANULATION
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MICROSCOPIC MICROSCOPIC
MULTIPLE FOCI OF GRANULOMATOUS INFLAMMATIONMULTIPLE FOCI OF GRANULOMATOUS INFLAMMATION
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XANTHELASMA XANTHELASMA SHARPLY DEMARCATED YELLOWISH SHARPLY DEMARCATED YELLOWISH
(COLLECTION CHOLESTEROL) -(COLLECTION CHOLESTEROL) -UNDERNEATH SKINUNDERNEATH SKIN
USUALLY : ON / AROUND EYELIDSUSUALLY : ON / AROUND EYELIDS
ASSOCIATIONS :ASSOCIATIONS :• CHOLESTEROL CHOLESTEROL ↑↑ (FAMILIAL HYPERCHOL) (FAMILIAL HYPERCHOL) • PRIMARY BILIARY CIRRHOSIS PRIMARY BILIARY CIRRHOSIS • MENOPAUSE MENOPAUSE • DIABETES DIABETES
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EXOPTHALMUSEXOPTHALMUS( = PROPTOSIS )( = PROPTOSIS )
PROTUSION (EYEBALL)PROTUSION (EYEBALL)
BILATERALBILATERAL
THYROID DISEASETHYROID DISEASE
EARLY ADULT LIFE (WOMEN), 4/1EARLY ADULT LIFE (WOMEN), 4/1
+ EDEMA (EYELID, CHEMOSIS)+ EDEMA (EYELID, CHEMOSIS)
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EXOPTHALMUSEXOPTHALMUS( = PROPTOSIS )( = PROPTOSIS )
PATHOLOGY:PATHOLOGY:• ORBITAL WATER >>ORBITAL WATER >>• EXT.OCULAR MUSCLE >>EXT.OCULAR MUSCLE >>
( + LYMPHOCYTES & MN )( + LYMPHOCYTES & MN )
CLINIC : CLINIC : • EXPOSURE CONJ’TIVA EXPOSURE CONJ’TIVA BLIDING, BLIDING,
ULCERATION, OPTIC NERVE ULCERATION, OPTIC NERVE COMPRESSIONCOMPRESSION
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CONJUNCTIVA DISORDERCONJUNCTIVA DISORDER
HYPEREMIAHYPEREMIA HEMORRHAGEHEMORRHAGE INFLAMATIONINFLAMATION THRACHOMATHRACHOMA CHLAMYDIAL INFECTIONCHLAMYDIAL INFECTION OPHTHALMIA NEONATORUMOPHTHALMIA NEONATORUM DRY-EYE SYNDROMEDRY-EYE SYNDROME PINGUECULA & PTERYGIUMPINGUECULA & PTERYGIUM
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HYPEREMIA - CONJUCTIVAHYPEREMIA - CONJUCTIVA
DILATASI BLOOD VESELDILATASI BLOOD VESEL CONJUNCTIVITISCONJUNCTIVITIS CORNEA DISEASECORNEA DISEASE IRIDOCYCLITISIRIDOCYCLITIS CORNEA DEFECTCORNEA DEFECT GLAUCOMAGLAUCOMA IRITISIRITIS
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HEMORRHAGE CONJUNCTIVAHEMORRHAGE CONJUNCTIVA
TRAUMATRAUMA ANOXIAANOXIA SEVERE COUCHING SEVERE COUCHING SPONTANEUS SPONTANEUS
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SUBCONJUNCTIVAL HEMORRHAGE SUBCONJUNCTIVAL HEMORRHAGE
Causes :Causes :
• Minor eye trauma Minor eye trauma • Spontaneously (venous Spontaneously (venous
press press ↑)↑) • Streneuous Exercising Streneuous Exercising • Coughing Coughing • Touching/widening eyes Touching/widening eyes • Sneezing Sneezing • Vomiting (bulimia nervosa) Vomiting (bulimia nervosa) • Severe alcohol intoxication, Severe alcohol intoxication,
blood press blood press ↑↑ • Severe hypertension Severe hypertension
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CONJUNCTIVITISCONJUNCTIVITIS
MICRO-ORG MICRO-ORG CONJUNCTIVITIS CONJUNCTIVITIS
KERATITISKERATITIS
CORNEAL ULCERCORNEAL ULCER
HEMATOGEN HEMATOGEN
IATROGENIC INFECTIONIATROGENIC INFECTION
SURGICAL : SURGICAL : CATARACTCATARACT CORNEAL GRAFTCORNEAL GRAFT PROSTHETIC LENSPROSTHETIC LENS
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CONJUNCTIVITISCONJUNCTIVITIS
EXUDATE/DISCHARGE :EXUDATE/DISCHARGE :
- PURULENT - PURULENT CLOSE CLOSE
- FIBRINOUS- FIBRINOUS
- SEROUS- SEROUS
- HEMORRHAGIC- HEMORRHAGIC
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CONJUNCTIVITISCONJUNCTIVITIS
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TRACHOMATRACHOMA INF.CHRONIC (CLAMYDIA TRACHOMATIS)INF.CHRONIC (CLAMYDIA TRACHOMATIS) = SWIMMING POOL CONJUNCTIVITIS= SWIMMING POOL CONJUNCTIVITIS
OCULAR, GENITAL, SYST’MICOCULAR, GENITAL, SYST’MIC BLIND BLIND
CHILD CHILD REMISION (SP) REMISION (SP)
ADULT ADULT PROGRESSIVE PROGRESSIVE
BILATERAL, SUP > INF BILATERAL, SUP > INF
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NEW BORN :NEW BORN : PURULENT CONJUNC. PURULENT CONJUNC. (BLENORRHOE)(BLENORRHOE)
ADULT :ADULT :• CHRONIC FOLLICLE CONJ. CHRONIC FOLLICLE CONJ. • LYMPHOCYTE (+)LYMPHOCYTE (+)• HYPERPLASIA HYPERPLASIA GERM. CENTRE NECROTIC GERM. CENTRE NECROTIC • TRACHOMATOUS PANNUSTRACHOMATOUS PANNUS
(EPIT – BOWMANN ZONE)(EPIT – BOWMANN ZONE)• FIBROSIS (CONJ. & EYELIDS) FIBROSIS (CONJ. & EYELIDS)
DISTORS EYELIDSDISTORS EYELIDS PATHOLOGY : PATHOLOGY :
• LOWER TARSAL CONJUNTIVALOWER TARSAL CONJUNTIVA• SCAR & NECROTIC (-)SCAR & NECROTIC (-)• KERATITIS (-)KERATITIS (-)
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TRACHOMATRACHOMA(CHLAMYDIAL CONJUNCTIVITIS)(CHLAMYDIAL CONJUNCTIVITIS)
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OPHTHALMIA NEONATORUMOPHTHALMIA NEONATORUM
ACUTE ACUTE SEVERE CONJUNCTIVITIS SEVERE CONJUNCTIVITIS COPIUS PURULENT DISCHARGECOPIUS PURULENT DISCHARGE GO GO GO-NEONATORUM GO-NEONATORUM ULC.CORNEA, PERFORATION ULC.CORNEA, PERFORATION
SCAR & PANOPH’ITIS SCAR & PANOPH’ITIS BLIND BLIND PREVENT PREVENT SILVER NITRAT (PNC) SILVER NITRAT (PNC)
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OPTHALMIA NEONATORIUMOPTHALMIA NEONATORIUM
Microbial Agent : Neisseria gonorrhoeae Mode of Transmission: From mother to
newborn Classic Feature: purulent destructive
eye disease
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DRY EYE SYNDROMEDRY EYE SYNDROME Common condition Common condition
Tear production << (ocular & systemic disease)Tear production << (ocular & systemic disease)
Older Older ♀♀ , menopause , menopause
Assc.: Assc.: “SJOGREN DISEASE”“SJOGREN DISEASE” (keratoconjunctivitis (keratoconjunctivitis sicca) sicca)
middle aged middle aged ♀♀ (atrophy of lacrimal glands) (atrophy of lacrimal glands)
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Common causes :Common causes :• AgingAging• Dry environment or workplace (wind, air Dry environment or workplace (wind, air
conditioning) conditioning) • Sun exposure Sun exposure • Smoking / smoke exposure Smoking / smoke exposure • Cold / allergy medicines Cold / allergy medicines • Sjogren's syndrome Sjogren's syndrome includes dry eyes, mouth & mucus includes dry eyes, mouth & mucus
membranesmembranes often RA / other joint disorderoften RA / other joint disorder
The result of :The result of :• Sensitivity of the cornea Sensitivity of the cornea ↓↓• Evaporation of tears Evaporation of tears ↑↑• Disorder in the glands Disorder in the glands
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PINGUECULAPINGUECULA
LUMP LUMP YELLOWISH YELLOWISH NASAL TO THE CORNEOSCLERALNASAL TO THE CORNEOSCLERAL SUN DAMAGED SUN DAMAGED INJURY INJURY DOES NOT GROW ONTO CORNEA DEPOSIT OF PROTEIN & FAT PARTICULARLY OLDER PEOPLE
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PINGUECULAPINGUECULA
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PTERYGIUM FOLD OF VASCULARIZED – RECURS AFTER EXISION FOLD OF VASCULARIZED – RECURS AFTER EXISION
(PINGUECULA)(PINGUECULA)
GROWS : TRIANGULAR SHAPE OVER THE CORNEA (THE TRANSPARENT PART OR FRONT WINDOW OF THE EYEBALL).
MAY GROW LARGE ENOUGH TO INTERFERE WITH VISION
COMMONLY : INNER CORNER OF THE EYE (APEX – PUPIL)
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PTERYGIUM
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CLOUDY CORNEA CLOUDY CORNEA CORNEA : TRANSPARENT CORNEA : TRANSPARENT
STRUCTURE STRUCTURE
LESS TRANSPARENT & LESS TRANSPARENT & CLOUDY :CLOUDY :• METABOLIC DISEASESMETABOLIC DISEASES• TRAUMATRAUMA• INFECTIOUS DISEASESINFECTIOUS DISEASES• NUTRITIONAL NUTRITIONAL
DEFICIENCIES &DEFICIENCIES &• ENVIRONMENTAL ENVIRONMENTAL
IT CAN LEAD TO VARIOUS IT CAN LEAD TO VARIOUS DEGREES OF VISION LOSS. DEGREES OF VISION LOSS.
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CORNEACORNEA
HERPES SIMPLEXHERPES SIMPLEX ONCHOCERCIASISONCHOCERCIASIS ARCUS SENILISARCUS SENILIS BAND KERATOPATHYBAND KERATOPATHY CORNEAL DYSTROPHIESCORNEAL DYSTROPHIES
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HERPES KERATITISHERPES KERATITIS
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HYPEREMIAHYPEREMIA(TRAUMA)(TRAUMA)
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EYE LENS ANATOMY EYE LENS ANATOMY
THE LENS OF THE EYE IS NORMALLY CLEAR.
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LENSLENS
CATARACTCATARACT PRESBYOPIAPRESBYOPIA PHACO ANAPHYLACTIC PHACO ANAPHYLACTIC
ENDOPHTHALMITISENDOPHTHALMITIS
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CATARACTCATARACT
THE LENS OF THE EYE IS NORMALLY CLEAR. IF THE LENS BECOMES CLOUDY OR IS OPACIFIED IT IS CALLED A CATARACT
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NORMAL, NEAR & FARSIGHTEDNESS
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UVEAUVEA
SYMPATHETIC OPHTHALMITISSYMPATHETIC OPHTHALMITIS SARCOIDOSISSARCOIDOSIS
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RETINARETINA
HEMORRHAGEHEMORRHAGE OCCLUSIVE VASC.DISEASEOCCLUSIVE VASC.DISEASE
- CENTRAL R. ART.OCCLUSION- CENTRAL R. ART.OCCLUSION
- CENTRAL R. VEIN OCCLUSION- CENTRAL R. VEIN OCCLUSION HYPERTENSIVE RETINOPATHYHYPERTENSIVE RETINOPATHY DIABETIC RETINOPATHYDIABETIC RETINOPATHY RETINAL DETACHMENT RETINAL DETACHMENT
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RETINARETINA
RETINITIS PIGMENTOSARETINITIS PIGMENTOSA MACULAR DEGENERATIONMACULAR DEGENERATION CHERRY-RED SPOT AT THE MACULACHERRY-RED SPOT AT THE MACULA ANGIOID STREAKSANGIOID STREAKS RETINOPATHY OF PREMATURITYRETINOPATHY OF PREMATURITY
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OPTIC NERVEOPTIC NERVE
OPTIC NERVE HEAD EDEMAOPTIC NERVE HEAD EDEMA OPTIC ATROPHYOPTIC ATROPHY
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EFFECTS OF INCREASE EFFECTS OF INCREASE INTRAOCULAR PRESSUREINTRAOCULAR PRESSURE
GLAUCOMAGLAUCOMA CORNEA/SCLERA CORNEA/SCLERA
BULGESBULGES OPTIC ATROPHYOPTIC ATROPHY
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GLAUCOMA GLAUCOMA
Increased pressure Increased pressure causes compression of :causes compression of :
Retina and Retina and Optic nerve Optic nerve Nerve Nerve
damage. damage.
Glaucoma can cause :Glaucoma can cause :• Partial vision loss, Partial vision loss, • Blindness as a possible Blindness as a possible
eventual outcome. eventual outcome.
GLAUCOMA IS A CONDITION OF INCREASED FLUID GLAUCOMA IS A CONDITION OF INCREASED FLUID PRESSURE INSIDE THE EYE.PRESSURE INSIDE THE EYE.
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GLAUCOMAGLAUCOMA
CONGENITAL GLAUCOMACONGENITAL GLAUCOMA INFANTILE GLAUCOMA, INFANTILE GLAUCOMA,
BUPHTHALMOSBUPHTHALMOS PRIMARY OPEN-ANGLE GLAUCOMAPRIMARY OPEN-ANGLE GLAUCOMA PRIMARY CLOSED-ANGLE GLAUCOMAPRIMARY CLOSED-ANGLE GLAUCOMA SECONDARY GLAUCOMASECONDARY GLAUCOMA LOW-TENSION GLAUCOMALOW-TENSION GLAUCOMA
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GLAUCOMAGLAUCOMA
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NEOPLASMANEOPLASMA
XANTHELASMAXANTHELASMA NEUROFIBROMANEUROFIBROMA PAPILLOMAPAPILLOMA LIPOMALIPOMA HEMANGIOMAHEMANGIOMA LIMPHANGIOMALIMPHANGIOMA NEVUSNEVUS
BENIGNBENIGN MALIGNANTMALIGNANT
BOWEN DISEASEBOWEN DISEASE SQ.CELL.CASQ.CELL.CA BASAL CELL CABASAL CELL CA MALIG. MELANOMAMALIG. MELANOMA AD. CARCINOMAAD. CARCINOMA SARCOMASARCOMA LYMPHOMALYMPHOMA
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XANTHELASMAXANTHELASMA
HYPERCHOLESTEROLEMIA HYPERCHOLESTEROLEMIA DM DM REPRODUCTION WOMANREPRODUCTION WOMAN LOC : LOC : CANTUS INTERNAL CANTUS INTERNAL PAL PAL
PEBRAE XANTHELASMAPEBRAE XANTHELASMA FOAMY CELLS FOAMY CELLS MICRO INTRA CYTOMICRO INTRA CYTO
PLASMA VACUOLE.PLASMA VACUOLE.
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NEUROFIBROMANEUROFIBROMA
SINGLE OR MULTIPLE SINGLE OR MULTIPLE NEUROFIBRONEUROFIBRO
MATOSIS (VON RECKING HAUSEN.D)MATOSIS (VON RECKING HAUSEN.D) LOC. LOC. PALPEBRAEPALPEBRAE OTHER SITE (+)OTHER SITE (+)
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PAPILLOMAPAPILLOMA STOLK (+) STOLK (+) SQ.EPITH.CELL SQ.EPITH.CELL PROLIFERATION PROLIFERATION
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LYMPHANGIOMALYMPHANGIOMA
LESS COMMONLESS COMMON LYMPH VESSELLYMPH VESSEL PROLIFERATION PROLIFERATION LUMPLUMP
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NEVUSNEVUS
EPITHELIAL CELLSEPITHELIAL CELLS NEVI CELLSNEVI CELLS TYPETYPE : - INTRA DERMAL: - INTRA DERMAL
- JUNCTIONAL- JUNCTIONAL
- COMPOUND- COMPOUND
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BOWEN DIASEASEBOWEN DIASEASE
INTRA EPITHELIAL NEOPLASMINTRA EPITHELIAL NEOPLASM CA INSITUCA INSITU ATIPICAL CELLSATIPICAL CELLS PLEOMORFISMPLEOMORFISM UNCOMMONUNCOMMON
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SQUAMOUS CELL CASQUAMOUS CELL CA
EPITHELIAL CELLSEPITHELIAL CELLS FORM : - NON KERATINIZINGFORM : - NON KERATINIZING
- KERATINIZING- KERATINIZING PLEOMORFISM CELLSPLEOMORFISM CELLS HYPERCHROMATIC NUCLEUSHYPERCHROMATIC NUCLEUS KERATIN (+/-) KERATIN (+/-)
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BASAL CELL CABASAL CELL CA
BASAL CELLSBASAL CELLS MONOTONMONOTON NUCLEUS NUCLEUS BASOPHYLIC BASOPHYLIC STRANDSTRAND PALISADE (+)PALISADE (+)
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MALIGNANT MELANOMAMALIGNANT MELANOMA
UVEAL MELANOMAUVEAL MELANOMA MELANOCYTE OR NEVI CELLSMELANOCYTE OR NEVI CELLS CHOROID (COMMON SITE)CHOROID (COMMON SITE) TYPE : MELANOCYTE/AMELANOCYTETYPE : MELANOCYTE/AMELANOCYTE MACRMACR : - CIRCUMSCRIBED: - CIRCUMSCRIBED
- INV.BRUCH’S MEMBRANE- INV.BRUCH’S MEMBRANE MICRMICR: - SPINDLE CELLS : - SPINDLE CELLS
- POLYGONAL CELLS- POLYGONAL CELLS
- EPITHELOID CELLS- EPITHELOID CELLS
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ADENO CARCINOMAADENO CARCINOMA
GLAND PATERNGLAND PATERN UNCOMMONUNCOMMON DIFFERENTIATED :DIFFERENTIATED :
- WELL- WELL
- MODERATE- MODERATE
- POORLY- POORLY
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SARCOMASARCOMA
CONNECTIVE TISSUECONNECTIVE TISSUE RHABDO/LEIOMYO SARHABDO/LEIOMYO SA FIBRO SAFIBRO SA LIPO SALIPO SA
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LYMPHOMALYMPHOMA
LYMPHOID TISSUELYMPHOID TISSUE ROUND CELLSROUND CELLS MONOTONEMONOTONE TYPETYPE : - IMMATURE CELLS: - IMMATURE CELLS
- MATURE CELLS - MATURE CELLS
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RETINOBLASTOMARETINOBLASTOMA
IMMATURE CELLSIMMATURE CELLS CHILD ( >> )CHILD ( >> ) FIRST 2 YRS OF LIFE FIRST 2 YRS OF LIFE BIRTH ( +/- )BIRTH ( +/- )
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RETINOBLASTOMARETINOBLASTOMA
PATHPATH : - INTERNAL : - INTERNAL VITR.BODY VITR.BODY - EXTERNAL- EXTERNAL
CREAM COLOREDCREAM COLORED CALCIFIED CALCIFIED YELLOW YELLOW MICRMICR : - SMALL CELLS: - SMALL CELLS
- ROUND CELLS- ROUND CELLS - ROSET (+)- ROSET (+) - NECROSIS- NECROSIS - HEMORRHAGIC - HEMORRHAGIC
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RETINOBLASTOMARETINOBLASTOMA
EARLY DIAG EARLY DIAG OPERATIVE OPERATIVE SURVIVAL ( 90 % )SURVIVAL ( 90 % ) UNTREATED UNTREATED FATAL FATAL INCIDENT 1/20000 (BIRTH)INCIDENT 1/20000 (BIRTH) FAMILIAL ( 5 – 10 % )FAMILIAL ( 5 – 10 % ) CHROMOSOME 13 (-) CHROMOSOME 13 (-) Q 14 BAND Q 14 BAND
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RETINOBLASTOMARETINOBLASTOMA
CLINICCLINIC : : WHITE PUPILS ( LEUCORIA)WHITE PUPILS ( LEUCORIA) POOR VISIONPOOR VISION HYPEMIAHYPEMIA STARBISMUSSTARBISMUS REDRED PAINFUL EYEPAINFUL EYE
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INTRAOCULAR PHOTOGRAPH OF AN INTRAOCULAR PHOTOGRAPH OF AN ISOLATED ISOLATED
"ENDOPHYTIC" RETINOBLASTOMA"ENDOPHYTIC" RETINOBLASTOMA
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GLIOMA NERVE OPTICUSGLIOMA NERVE OPTICUS
UNCOMMONUNCOMMON CHILD AND ADULTCHILD AND ADULT NEUROFIBROMATOSIS NEUROFIBROMATOSIS GLIOMA GLIOMA VISION VISION << (PROGRESIVA) << (PROGRESIVA) PROPTOSISPROPTOSIS PAPIL EDEMA PAPIL EDEMA MICRMICR : - ASTROSITOMA LIKE CELLS: - ASTROSITOMA LIKE CELLS
- WELL DIFFERENTIATED- WELL DIFFERENTIATED SURGICAL AND RADIOTH/ SURGICAL AND RADIOTH/ OK OK 5 YSR 5 YSR 90 % 90 %
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METASTATIC NEOPLASMMETASTATIC NEOPLASM
MORE COMMON X PRIMERMORE COMMON X PRIMER PRIMER LESSION :PRIMER LESSION :
- LEUKEMIA- LEUKEMIA
- BREAST CA- BREAST CA
- LUNG CA- LUNG CA DIAG : DIAG : AFTER DEATH AFTER DEATH
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