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Ocular Pathology and Intraocular Tumors > Orbit > Flashcards

Orbit Flashcards

1
Q

7 bones of orbit

A

frontal, zygomatic, maxillary, lacrimal, ethmoid, sphenoid, palatine

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2
Q

volume of orbit

A

30cc

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3
Q

Most common congenital orbital cyst? Most common location?

A

dermoid cyst. superotemporal

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4
Q

3 most common pediatric orbital tumors?

A

dermoid cyst, capillary hemangioma, rhabdomyosarcoma

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5
Q

Early and late histology of NSOI/orbital pseudotumor/IOI

A

Early polymorphous infiltrate. Late fibrosis with interspersed lymphoid follicles. Affects any orbital tissue, including tendons (TED spares tendons). Perivenulitis can be a prominent feature

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6
Q

Most common cause of unilateral proptosis in adults? Bilateral?

A

TED. TED.

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7
Q

Histology of TED?

A

Inflammation of orbital connective tissue, inflammation and fibrosis of EOMs that spares tendons, adipogenesis

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8
Q

Most common muscles affected by TED?

A

Inferior and medial recti

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9
Q

What type of cell is upregulated 100-fold in TED?

A

orbital fibroblast (neural crest derivative)

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10
Q

Broad, nonseptated hyphae from orbital biopsy in patient with poorly-controlled DM?

A

mucormycosis (zygomycosis). Invade blood vessel walls and cause thrombosing vasculitis

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11
Q

Slowly progressive orbital inflammation, biopsy shows septated hyphae with 45 degree branching?

A

Sino-orbital Aspergillosis. Hard to treat, can be fatal if invades brain

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12
Q

Noninvasive fungal disease characterized by IgE hypersenitivity in atopic individuals?

A

Allergic fungal sinusitis

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13
Q

Most common primary orbital neoplasm in adults? 2nd MC?

A

lymphoma. 2nd: hemangioma

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14
Q

Most common orbital malignancy in children?

A

rhabdomyosarcoma

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15
Q

3 most common types of lacrimal gland tumors? Which is most common?

A

pleomorphic adenoma (benign mixed tumor), adenoid cystic carcinoma, adenocarcinoma

pleomorphic adenoma is most common

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16
Q

What immuno marker may be elevated in the sclerosing variant of IOI?

A

IgG4

17
Q

granulomatous inflammation with vasculitis and necrosis?

A

Wegeners / microscopic polyangiitis with ganulomatosis

18
Q

Biopsy of painless superotemporal orbital lesion reveals pseudoencapsulated mass with mixture of ductal-derived epithelial and stromal elements

A

pleomorphic adenoma of lacrimal gland. **Recur with incomplete excision, and recurrences can develop into adenoid cystic carcinoma

19
Q

Biopsy in a 40 yo woman of a painful superotemporal orbital lesion reveals nonencapsulated mass with a Swiss-cheese pattern of ductal-like epithelial cells? Type of spread?

A

Adenoid cystic carcinoma. Pernieural spread

20
Q

Red discoloration of child’s eyelid without fever or warmth?

A

Think Rhabdo!

21
Q

Types of rhabdo? Most common? Best prognosis? Worst prognosis?

A

embryonal (most common), botryoid (best prognosis), alveolar (worst prognosis), pleomoprhic

22
Q

Immunohistochemical markers for rhabdo?

A

desmin, muscle-sepcific actin, vimectin

23
Q

Poorly cohesive rhabdomyoblasts separated by fibrous septae?

A

alveolar rhabdomyosarcoma

24
Q

Workup for patient with suspected orbital lymphoma?

A

Biopsy of accessible lymph node preferred over orbital biopsy. *Include systemic workup: lymph node exam, CBC w/ dif, imaging of thorax and abdomen

25
Q

Orbital biopsy reveals well differentiated lymphoid hyperplasia with germinal centers?

A

Reactive lymphoid hyperplasia

26
Q

Orbital biopsy reveals diffuse lymphoid proliferation without germinal center?

A

Atypical lymphoid hyperplasia

27
Q

Orbital biopsy reveals diffuse lymph nodal architecture with monoclonal expansion of CD20 cells?

A

B cell lymphoma

28
Q

One half of malignancies arising in orbit and adnexa are___.

A

Non-Hodgkin lymphoma (includes B and T cell. B cell much more common)

29
Q

Child presents with fluctuating unilateral proptosis. Biopsy reveals an unencapsulated mass of lymphatic vascular spaces and lymphoid aggregates in a fibrotic intersitium

A

lymphangioma

30
Q

Most common spindle cell tumor of orbit? Most common orbital location? Immunohistochemistry stains?

A

fibrous hostiocytoma (fibroxanthoma). superonasal. CD45 and CD68

31
Q

42 yo p/w painful proptosis and diplopia. Orbital biopsy shows staghorn vascular pattern with densely packed spindle cells that stain positive for CD34

A

hemangiopericytoma

32
Q

Most common nerve sheath tumor in the orbit?

A

neurofibroma

33
Q

Describe the 2 patterns of Schwannomas

A

Antoni A: densely packed spindle cells. Palisading of nuclei may for a Verocay body
Antoni B: loosely arranged mucoid stroma, represents degeneration within the tumor

34
Q

Ground glass appearance with lytic foci and narrowing of optic canal on plain radiograph?

A

fibrous dysplasia

35
Q

Most common orbital met in children? Women? Men?

A

neuroblastoma. breast. prostate

Ocular Pathology and Intraocular Tumors (15 decks)

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