Eyelids Flashcards
acanthosis
hyperplasia of the stratum malpighii (s. basale, s. spinosum, s. granulosum)
hyperkeratosis
increased thickness of stratum corneum
parakeratosis
retention of nuclei in stratum corneum with correspoding absence of s. granulosum
papillomatosis
formation of fingerlike upward projections of epidermis lining fibrovascular cores
dyskeratosis
premature individual cell keratinization within the stratum malpighii
acantholysis
loss of cohesion between adjacent epithelial cells
spongiosis
widening of intercellular spaces between cells in the stratum malpighii due to edema
Normal eyelid skin histology?
keratinized stratified squamous epithelium, APCs (melanocytes and Langerhans cells). Dermis with cilia and associated sebaceous glands of Zeis, apocrine sweat glands of Moll, eccrine sweat glands, and pilosebaceous units
Two types and the locations of accessory lacrimal glands?
Wolfring (superior tarsus) and Krause (fornices)
layers of eyelid at level of tarsus?
epidermis, dermis, orbicularis, tarsus, palpebral conjunctiva
Distichiasis
aberrant formation of cilia arriving from meibomian gland.
Zimmerman’s tumor
phakomatous choristoma; aberrant location of lens epithelium in inferonasal eyelid
Hordeolum
primary, acute, self-limited inflammation of glands of Zeis or less often meibomian glands
Histologic characteristics of papilloma?
hyperkeratosis, acanthosis, papillary growth patterns, koilocytosis, mixed inflammatory infiltrate in dermis
Dome-shaped, waxy epidermal nodule with central umbilication and follicular conjunctivitis? Histology of lesion?
Molluscum conatgiosum; nodular proliferation of infected epithelium with central necrosis. Large viral inclusions displace nuclei peripherally
Histology of chalazion?
lipogranulomatous inflammation of meibomian gland (or less likely gland of Zeis)
Soft yellow plaques near medial canthus? Systemic correlations?
xanthelasma; hyperliporpoteinemia
Difference between epidermal and dermal inclusion cyst?
Both are keratin-filled cysts lined with stratified squamous epithelium. Dermal cysts include adnexal structures (hair follicles and sebaceous glands), and their lumens also contain hair and sebum
Histology of apocrine hidrocystoma?
Cyst lined by double layer of cuboidal epithelium. Epithelial cells demonstrate decapitation secretion
histology of stuck-on, brown, dome-shaped lesion?
(seborrheic keratosis) hyperkeratosis, acanthosis, papillomatous growth, concentric collections of surface keratin (pseudohorn cysts)
sudden onset of multiple seborrheic keratosis?
Leser-Trelat sign, which is a harbinger of malignancy (usually GI adenocarcinoma)
Diagnosis and histology of rapidly growing, dome-shaped nodule with central keratin-filled crater
keratoacanthoma. well-differentiated squamous cells arranged in nests and strands, with possible mitotic activity or nuclear atypia
Diagnosis and histology of erythematous, scaly macule or papule in sun-exposed area?
actinic keratosis. hyperkeratosis and parakeratosis with underlying solar elastosis and chronic inflammatory infiltrate. possibly with dyskeratosis or mitotic figures
most common malignant neoplasm of eyelid?
BCC (90% of all eyelid malignancies)
Dx and histology of pearly nodule with central umbilication on lower eyelid?
nodulr variant of BCC. cohesive islands of abnormal basal cells with nuclear pallisading of the peripheral cell layer
abnormal epithelial cells in nests invading into dermis and inciting a fibrotic tissue variant
SCC
thin cords and strands of basaloid tumor cells in a fibrotic dermis
morpheaform (sclerosing) BCC
% of regional lymph node metastasis in SCC?
20%
histology of capillary hemangioma
unencapsulated proliferation of endothelial cells with vascular lumen formation
Diagnosis, clinical appearance, and origin of multiple comma-shaped or round ductules lined with a double layer of epithelium with central lumen, often with secretory material
Syringoma. Multiple tiny papules on lower eyelid. Malformation of eccrine sweat glands
most common location of sebaceous carcinoma
upper eyelid (more meibomian glands)
Diagnosis and systemic correlation of yellow circumscribed eyelid nodule with pathology showing multiple sebaceous lobules irregularly shaped and incompletely differentiated?
sebaceous adenoma. Muir-Torre syndrome
How should a clinician prepare a suspected sebaceous carcinoma biopsy for the pathologist?
make sure to include frozen sections so that lipid staining can be performed with Sudan black or oil red O
chronic unilateral blepharitis with madarosis
sebaceous carcinoma
most common type of melanoma occurring on the eyelids>
lentigo maligna
