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Primary anaplastic lymphoma kinase-positive large B-cell lymphoma of the left bulbar conjunctiva: A case report

World Journal of Clinical Cases 2024年第3期12卷 657-664页

作者： Xiao-Hong Guo Chu-Bin Li Hui-Hui Cao Gen-Yuan Yang Department of Pathology Zhuhai People's Hospital(Zhuhai Hospital Affiliated with Jinan University)Zhuhai 519000Guangdong ProvinceChina Endoscopy Center Zhuhai People's Hospital(Zhuhai Hospital Affiliated with Jinan University)Zhuhai 519000Guangdong ProvinceChina

BACKGROUND Anaplastic lymphoma kinase(ALK)-positive large B-cell lymphoma(LBCL)is an aggressive and rare variant of diffuse LBCL.Herein,we report an uncommon case of stage IE extranodal ALK-positive LBCL initially originating in the bulbar con-junctiva.CASE SUMMARY A 63-year-old woman presented with a mass in the left bulbar conjunctiva that had persisted for six months,accompanied by swelling and pain that had per-sisted for 3 d.Eye examination revealed an 8 mm slightly elevated pink mass in the lower conjunctival sac of the left eye.Microscopically,the tumor was com-posed of large immunoblastic and plasmablastic large lymphoid cells with scattered anaplastic or multinucleated large cells.Immunophenotypically,the neoplastic cells were positive for ALK,CD10,CD138,Kappa,MUM1,BOB.1,OCT-2,CD4,CD45,EMA,CD79a,CD38,and AE1/AE3,and negative for CD20,PAX5,Lambda,BCL6,CD30 and all other T-cell antigens.The results of gene rearrangement tests showed monoclonal IGH/IGK/IGL and TCRD rearran-gements.Fluorescence in situ hybridization studies did not reveal any BCL2,BCL6 or MYC rearrangements.Furthermore,Epstein-Barr virus was not detected by in situ hybridization in the lesions.Based on the histopathological and imaging examinations,the neoplasm was classified as stage IE ALK-positive LBCL.No further treatments were administered.At the 6,15,and 21 mo postoperative follow-up visits,the patient was in good condition,without obvious discomfort.This case represents the first example of primary extranodal ALK-positive LBCL presenting as a bulbar conjunctival mass,which is extremely rare and shares morphological and immunohistochemical features with a variety of other neo-plasms that can result in misdiagnosis.CONCLUSION Awareness of the condition presented in this case report is necessary for early and accurate diagnosis and appropriate treatment.

关键词： Anaplastic lymphoma kinase Large B-cell lymphoma conjunctiva Immunoglobulin/T-cell receptor gene Immunohistochemistry Case report

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Epidemio-Clinical-Histopathological Aspects and Therapeutics of Squamous Cell Carcinoma of the conjunctival at the University Hospital Center of Bouake

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Open Journal of Ophthalmology 2024年第2期14卷 159-167页

作者： Philippe Emile France Koffi Bile Pierre Windinmanegde Djiguimde Gossé François Diomandé Zana Diabate Kouassi Franck-Hermann Koffi Liliale Ella Godé Ange Mickael Goule Opeyemi Babayeju Yves Ouattara Ibrahim Abib Diomande Ophthalmology Department University Hospital Center Bouake C&#244te d&#8217Ivoire Ophthalmology Department University Hospital Center Bogodogo Ouagadougou Burkina Faso

Introduction: Squamous cell carcinoma of the conjunctiva is one of the most common malignancies in the elderly. Purpose: To describe the specific aspects of squamous cell carcinoma of the conjunctiva and to determine the therapeutic modalities. Materials and Methods: Descriptive cross-sectional retrospective study carried out at the University Hospital Center of Bouake over a period of 9 years (From January 2015 to December 2023). We identified all malignant oculo-adnexal and orbital tumors whose histopathological diagnosis was confirmed;monitoring the sorting of squamous cell carcinomas of the conjunctiva among these cancers and studying the different parameters linked to them. Results: The average age of patients is 44.3 years. Male predominance with a sex ratio of 1.12. HIV was the majority ATCD with 64.7%. The main reason for consultation was exophthalmos (36.11%). The average consultation time was 10 months 13 days. Invasive differentiated conjunctival squamous cell carcinoma was predominant at 55.56%. Enucleation was the most performed surgical method. Conclusion: Squamous cell carcinoma of the conjunctiva is a malignant ocular tumor of the elderly whose frequency increases in young adults infected with HIV-AIDS. Invasive differentiated forms are increasingly encountered, limiting treatment to mutilating surgery.

关键词： Malignant Tumor Ocular Carcinoma conjunctiva

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Detection of anemia using conjunctiva images:A smartphone application approach

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Medicine in Novel Technology and Devices 2023年第2期18卷 169-180页

作者： Peter Appiahene Enoch Justice Arthur Stephen Korankye Stephen Afrifa Justice Williams Asare Emmanuel Timmy Donkoh Department of Computer Science and Informatics University of Energy and Natural ResourcesSunyaniGhana Department of Basic and Applied Biology University of Energy and Natural ResourcesSunyaniGhana

Anemia is one of the public health issues that affect children and pregnant women globally.Anemia occurs when the level of red blood cells within the body is reduced.Detecting anemia requires expert blood draw for clinical analysis of hemoglobin quantity.Although this standard method is accurate,it is costive and consumes enough time,unlike the non-invasive approach which is cost-effective and takes less time.This study focused on pallor analysis and used images of the conjunctiva of the eyes to detect anemia using machine learning techniques.This study used a publicly available dataset of 710 images of the conjunctiva of the eyes acquired with a unique tool that eliminates any interference from ambient light.We combined Convolutional Neural Networks,Logistic Regression,and Gaussian Blur algorithm to develop a conjunctiva detection model and an anemia detection model which runs on a Fast API server connected to a frontend mobile app built with React Native.The developed model was embedded into a smartphone application that can detect anemia by capturing and processing a patient's conjunctiva with a sensitivity of 90%,a specificity of 95%,and an accuracy of 92.50%on average performance in about 50 s.

关键词： Anemia detection Pallor analysis conjunctiva Machine learning Red blood cells

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Bare sclera resection followed by mitomycin C and/or autograft limbus conjunctiva in the surgery for pterygium:a Meta-analysis

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International Journal of Ophthalmology(English edition) 2015年第5期8卷 1067-1073页

作者： Tan Long Zhi Li Department of Ophthalmology Xi'an No.1 Hospital Department of Ophthalmology Xiangyang Central Hospital

AIM: To evaluate the recurrence and complications after bare sclera resection (BSR) combined with mitomycin C (MMC) treatment and/or autograft limbus conjunctiva (ALC) in the surgery for pterygium. METHODS: Meta -analysis was used to evaluate the differences in patient outcomes between BSR of pterygium with or without MMC and/or ALC. All included studies were randomized trials of patients with pterygium who received BSR followed by MMC and/or ALC in the surgery. The recurrence of pterygium and other complications resulting from different treatments were extracted for analysis. RESULTS: Thirteen studies met the inclusion criteria. The recurrence of pterygium with intraoperative (10) MMC was higher than that with ALC (OR=2.38,95% confidence interval 1.45-3.91, I-2=29%). Postoperative MMC resulted in an incidence of recurrence similar to that of ALC (OR= 0.66, 95% confidence interval 0.30-1.42, I-2=0%), and 10 MMC treatment in combination with ALC produced similar patient outcomes to ALC alone (OR =0.41, 95% confidence interval 0.16-1.01, I-2=16%). Other complications such as punctate epitheliopathy, scleral thinning and ischemia, irritation and persistent epithelium defect, were more common in patients in the MMC group as compared to those treated with ALC. CONCLUSION: The recurrence of pterygium with BSR followed by ALC is lower than that of BSR followed by MMC, and the incidence of other complications is lower. While ALC is a more effective strategy for treating pterygium, the quality of the ALC transplant should be considered when the patient has a history of glaucoma.

关键词： pterygium mitomycin C conjunctiva autogaft

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Characteristics, management, and outcome of squamous carcinoma of the conjunctiva in a single tertiary cancer center in Jordan

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International Journal of Ophthalmology(English edition) 2018年第7期11卷 1132-1138页

作者： Ata Rajeh Fareed Barakat Samer Khurma Khaleel Al Rawashdeh Osama H.Ababneh Ibrahim AlNawaiseh Mustafa Mehyar Ghadeer Abdeen Imad Jaradat Mona Mohammad Yacoub A.Yousef Department of Surgery (Ophthalmology) King Hussein Cancer Centre (KHCC) Department of Pathology King Hussein Cancer Centre (KHCC) Department of Ophthalmology The University of Jordan and Jordan University Hospital Department of Medical Oncology King Hussein Cancer Centre (KHCC) Department of Radiation Oncology King Hussein Cancer Centre (KHCC)

AIM： To evaluate the features and outcome of management of malignant conjunctival squamous tumors in King Hussein Cancer Center（a referral tertiary cancer center in the Middle East）. METHODS： Retrospective case series of 31 eyes for 31 patients with conjunctival squamous neoplasia. Main outcome measures included： age, gender, laterality, tumor location, pathological features, tumor stage, treatment modality, and outcome. RESULTS： Twenty（65%） patients were males and median age was 58 y. Twenty-two（71%） eyes had the tumor in the nasal quadrant. Tumor invasion to nearby structures was seen in 19（61%） eyes, including the cornea, fornix, eyelid, and orbit in 17（55%）, 1（3%）, 2（6%）, and 3（10%） eyes, respectively. Eye salvage was achieved by surgical excision with cryotherapy followed by topical chemotherapy in 28（90%） eyes, and orbital exenteration was necessary in 3（10%） eyes due to orbital tumor invasion. Tumor recurrence was seen in 7（23%） eyes, and the significant predictive factors for recurrence were tumor extension onto the nearby structures（P=0.04）, tumor invasiveness（P=0.038）, and tumor TNM stage（P=0.031）. No significant change in visual acuity was seen, and disease related mortality was 6%（2 patients, both had orbital invasion by invasive squamous carcinoma）. CONCLUSION： conjunctival squamous carcinoma is more common in males. Advanced American Joint Committee on Cancer（AJCC） T-stage, tumor local invasion, more pathologically aggressive tumors, and surgical treatment alone（without adjuvant therapy） are associated with higher risk for recurrence, and orbital invasion is the most important poor prognostic factor for metastasis and death. Treatment strategies should be affected by tumor characteristics at presentation.

关键词： conjunctiva squamous cell carcinoma metastasis

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Bacterial flora of conjunctiva after death

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International Journal of Ophthalmology(English edition) 2013年第5期6卷 632-636页

作者： Sagili Chandrasekhara Reddy George Paul Department of Ophthalmology Faculty of MedicineUniversity of Malaya Department of Forensic Pathology Faculty of MedicineUniversity of Malaya

AIM:To evaluate the frequency of bacterial flora of conjunctiva after death(cadaver eyes) which will give information about the bacterial contamination of donor eyes,and the in-vitro sensitivity of isolated bacteria to the commonly used antibiotics in ophthalmic practice.METHODS:conjunctival swabs were taken from the cadavers(motor vehicle accident deaths and patients who died in the hospital),within 6h after death,and sent for culture and sensitivity test.conjunctival swabs,taken from the healthy conjunctiva of patients admitted for cataract surgery,were sent for culture and sensitivity as controls(eyes in those of living status).The bacterial isolates were tested against the commonly used antibiotics(chloramphenicol,gentamicin,ciprofloxacin) in ophthalmology practice.RESULTS:Bacteria were isolated in 41 out of 100 conjunctival swabs(41%),taken from 50 cadavers(study group).Coagulase negative staphylococcus was the most common bacteria isolated(15%),followed by pseudomonas aeruginosa(5%).Gentamicin was effective against majority of the bacterial isolates(82%).Bacteria were isolated from 7 out of 100 conjunctival swabs taken as control group(eyes in living state).Coagulase negative staphylococcus was the most common organism(5%) isolated in control group;the others were staphylococcus aureus(1%) and beta hemolyticus streptococci(1%).CONCLUSION:Bacteria were isolated from 41% of the cadaver eyes.High percentage sensitivity of the bacterial isolates to gentamicin(82%) supports the practice of thorough irrigation of the eyes with gentamicin solution before starting the procedure of enucleation followed by immersion of the enucleated eyeballs in gentamycin solution,to prevent the bacterial contamination.

关键词： bacterial flora conjunctiva cadaver eyes cataract eyes

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Prevalence of HIV seropositivity among patients with squamous cell carcinoma of the conjunctiva

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Asian Pacific Journal of Tropical Biomedicine 2011年第2期1卷 150-153页

作者： Adesuwa I Osahon Catherine U Ukponmwan Odarosa M Uhunmwangho Department of Ophthalmology University of Benin Teaching Hospital

Objective:To determine the prevalence of HIV seropositivity among patients with squamous cell carcinoma of the conjunctiva.Methods:All patients with clinical and histopathological confirmation of squamous cell carcinoma seen during a ten year period(July 1999 to June 2009) were tested for HIV(Human Immunodeficiency Virus).The number of patients with squamous cell carcinoma of the conjunctiva who are HIV positive were counted.Results:A total of thirty-three(33) eyes in thirtytwo(32) patients were confirmed histopathologically to have conjunctival squamous cell carcinoma. Their ages ranged from 22 years to 66 yean with a mean age of(38.6± 11.8) years(SD).The male to female ratio was 1:1.5.Twenty four(75%) of these patients were HIV positive.Conclusions: Squamous cell carcinoma is associated with the human immunodeficiency virus and is thus a marker for the disease in Benin City,Nigeria.

关键词： Squamous cell carcinoma conjunctiva HIV

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Microcirculation in the conjunctiva and retina in healthy subjects

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Eye and Vision 2019年第1期6卷 81-86页

作者： Ce Shi Hong Jiang Giovana Rosa Gameiro Jianhua Wang School of Ophthalmology and Optometry Wenzhou Medical UniversityWenzhouZhejiangChina Bascom Palmer Eye Institute University of MiamiMiller School of Medicine1638 NW 10th AvenueMcKnight Building-Room 202AMiamiFL 33136USA

Background:The aim was to determine the relationship between bulbar conjunctival microcirculation and retinal microcirculation in a healthy population.Method:A functional slit-lamp biomicroscope(FSLB)was used to measure blood flow velocity(BFV)and blood flow rate(BFR)in the conjunctiva while a retinal function imager(RFI)was used to measure macular BFV and BFR in the retina.One eye of each subject of 58 self-reported healthy subjects was imaged in the same session on the same day.Results:The mean BFV in the venules of the conjunctiva was 0.49±0.13 mm/s,which was significantly slower than that in the retinal arterioles(3.71±0.78 mm/s,Pconjunctiva(0.09 nl/s)was also significantly lower than that in the retina(arterioles=0.81 nl/s,venules=0.68 nl/s,all Pconjunctiva and retina(r ranged from−0.17 to−0.05,all P>0.05).Conclusion:The microcirculation in the retina appeared to be different from that in the conjunctiva.

关键词： Variability Bulbar conjunctiva Blood flow velocity Microvascular network Functional slit-lamp biomicroscopy(FSLB) Hemodynamics Microcirculation Retina conjunctiva Retinal function imager

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Management of Epidermoid Carcinoma of the conjunctiva in a Melanoderma Subject in a Secondary Ophtalmology Centre: About a Case

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Surgical Science 2021年第11期12卷 351-356页

作者： Moro Sidibe Abdoulaye Napo Adama Dembele Oumar Diallo Djonnyjonas Dembele Mamadou Adama Togo Kadiatou Ba Koita Ibrahima Conare Abdoulaye Nouhoum Coulibaly Vonor Kokou Benjamin Moussa Diassana Jeannette Traore Fatoumata N’diaye Sikasso Regional Hospital Mali/Alliance for the Development of Community Ophthalmology (ADOC) Bamako Mali Alliance for the Development of Community Ophthalmology (ADOC) Bamako Mali Institute of Tropical Ophthalmology of Africa Bamako Mali/Alliance for the Development of Community Ophthalmology (ADOC) Bamako Mali Kara Regional Hospital Center TOGO

We report a case of a unilateral conjunctival neoformation in a 44-year-old female melanoderma subject. It was a conjunctival squamous cell carcinoma (CSC). The risk factor was exposure to sunlight and dust. No HIV or HPV infection was found. The treatment consisted of simple removal of the tumour with a healthy margin of 3 to 4 mm. After a postoperative follow-up of 18 months, there was no recurrence. As CSC is the most common conjunctival malignancy and given the rate of recurrence with the possibility of associated local invasion, early diagnosis with long-term follow-up is necessary.

关键词： Carcinoma conjunctiva Surgery Sikasso Mali

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conjunctival microbiome changes associated with fungal keratitis: metagenomic analysis

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International Journal of Ophthalmology(English edition) 2019年第2期12卷 194-200页

作者： Cheng Ge Chao Wei Bao-Xia Yang Jun Cheng Yu-Sen Huang Department of Medicine Qingdao University State Key Laboratory Cultivation Base Shandong Provincial Key Laboratory of Ophthalmology Shandong Eye Institute Shandong Academy of Medical Sciences

AIM: To investigate the ocular surface microbiome profile of patients with fungal keratitis(FK) through bacterial 16 S r DNA sequencing. METHODS: The swab samples were collected from 8 patients with FK(Group 1 from the corneal ulcer, Group 2 from the conjunctival sac of the infected eyes, and Group 3 from the conjunctival sac of the fellow eyes) and 10 healthy eyes(Group 4 from the conjunctival sac). Bacterial 16 S rDNA V4-V5 region sequencing was performed to characterize the bacterial communities on the ocular surfaces of the patients with FK. RESULTS: Our metagenomic data showed that 97% of the sequence reads were categorized into 245 distinct bacterial genera, with 67.75±7.79 genera detected in Group 1, 73.80±13.44 in Group 2, 74.57±14.14 in Group 3, and 89.60±27.49 in Group 4. Compared with the healthy eyes(Group 4), both infected(Groups 1 and 2) and fellow eyes(Group 3) of the patients with FK showed reduced bacterial diversity and altered ocular surface microbiota compositions, with lower abundance of Corynebacterium and Staphylo coccus and higher abundances of Pseudomonas, Achromobacter, Caulobacter and Psychrobacter. CONCLUSION: Our report depicts the altered ocular surface bacterial community structures both in the affected and fellow eyes of patients with FK. These changes may contribute to the pathogenesis of FK or the increased risk for FK.

关键词： conjunctiva microbiota bacteria metagenomics 16S rDNA fungal keratitis

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