Case Studies

CBLPath's team of ophthalmic pathologists utilizes the latest technologies, including special stains, to aid in achieving definitive diagnoses.

Case Study 1

A 67 year old man was seen by his ophthalmologist for a right upper eyelid/temple mass.
Histopathology
Histologic sections reveal different patterns of tumor growth. In one area there are sheets and aggregates of large cells with prominent and pleomorphic nucleoli and clear cytoplasm. In other areas the tumor cells appear more cohesive and spindly with abundant eosinophilic cytoplasm and indistinct cytoplasmic borders. There is a background population of small, well-differentiated lymphocytes sprinkled throughout the tumor.
Immunostain
Immunostains reveal these cells are lymphoid in origin, specifically CD79a positive revealing a “B” cell phenotype. “T” cell markers were negative as were keratins and melanocytic markers.
Diagnosis
Malignant lymphoma, B cell, anaplastic variant.

Case Study 2

A 45 year old woman visited her ophthalmologist for a routine check-up and reported some recent changes in a pigmented lesion on her eyelid.
Histopathology
Histologic sections reveal a lentiginous proliferation of atypical melanocytes with pleomorphic nuclei and prominent nucleoli. The cytoplasm contains pigment. There is focal nest formation with some melanocytes arranging parallel at the dermal-epidermal junction. A recent scar is also present as is extensive dermal solar elastosis. The margins of resection are negative for the melanocytic process.
Diagnosis
Lentigo maligna, excised.

Case Study 3

A 22 year old man went to the ophthalmologist for a non-resolving “stye.”
Histopathology
Sections reveal lipogranulomatous inflammation.
Diagnosis
Portion of eyelid margin with a chalazion.

Case Study 4

A 79 year old man complained of a crusting eyelid lesion.
Histopathology
Sections reveal a basaloid tumor with palisading margins. Mitotic figures are not obvious. There is ulceration of the overlying epidermis.
Diagnosis
Basal cell carcinoma, excised.