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Manual of Ocular Pathology
Jyotirmay Biswas, S Krishnakumar, Shweta Ahuja
PART I:
CHAPTER 1:
Introduction
OPHTHALMIC PATHOLOGY SPECIMENS
PATHOLOGIC STUDY
Processing of Biopsy Specimen
Processing of Tissues Includes
Fixation
GROSS EXAMINATION OF THE SPECIMENS
Eyeball Specimens
Steps
a. Identification of the Side of the Globe
b. Measurement of the Globe
c. Gross Inspection of the Eyeball
d. Transillumination
e. Sectioning of the Globe
f. Internal Description
Special Procedures
g. Tumor Sample Collection for Molecular Biological Studies
GROSSING OF OTHER SPECIMENS
Cornea
Lens
IOL
Lid, Conjunctiva, Orbital or Uveal Tissue
Stains Used in Ocular Pathology Lab (Table 1.1)
HANDLING OF SMALL BIOPSY SPECIMENS
HISTOLOGIC SECTIONS
IMMUNOHISTOCHEMICAL STAINING
CHAPTER 2:
Pathology of the Eyelid
CHAPTER 3:
Parthology of the Conjunctiva
HISTOLOGY
Epithelium
Stroma
Pathology
Congenital
Dermoid
Inflammation
Pathological Classification
Pathology
CONJUNCTIVAL DEGENERATIONS
Pterygium and Pinguecula
Pathology
Cysts
Tumors
Squamous Lesions
Types
i. Squamous papilloma
Pathology
ii. Conjunctival Dysplasia
iii. Carcinoma in situ
iv. Invasive Squamous Cell Carcinoma
Lymphoid Tumors
Benign Lesions (Reactive lymphoid hyperplasia)
Malignant Lesions (Malignant lymphoma)
Melanocytic Tumors
Primary Acquired Melanosis (PAM)
Malignant Melanoma
CHAPTER 4:
Pathology of the Cornea
HISTOLOGY
Stroma
1. Infections
A. Bacterial
B. Fungal
C. Viral
D. Protozoal (Acanthamoeba)
2. Dystrophies
3. Degeneration
4. Blood Staining of the Cornea
Corneal Graft Rejection
Descemet's Membrane
Endothelium
Structures Adherent to Corneal Surface
CHAPTER 5:
Pathlogy of the Lens
HISTOLOGY OF LENS
PATHOLOGY
I. Zonular Alterations
Marfan's Syndrome
Pathology
Homocystinuria
Weill-Marchesani Syndrome
II. Capsular Alterations
III. Epithelial Changes
IV. Lens Substance Alterations
CHAPTER 6:
Pathlogy of the Uvea
GRANULOMATOUS
Sympathetic Ophthalmia and Vogt-Koyanagi-Harada (VKH) Syndrome
CHAPTER 7:
Intraocular Tumors
RETINOBLASTOMA
Gross Examination
Findings
MICROSCOPIC EXAMINATION
Findings
Low Power
High Power
a. Poorly Differentiated
b. Well-differentiated
a. Rosettes
i. Homer-Wright Rosettes (Figure 7.7A)
ii. Flexner-Wintersteiner Rosettes (Figure 7.7B)
b. Fleurettes
Other Pathologic Features
Histopathologic Risk Factors and their Associations with Prognosis
Malignant Melanoma of the Choroid
Incidence
Age
Pathology
Pigmentation
Growth Pattern
i. Focal
ii. Diffuse
New AFIP Classification
Other Histologic Features Related to Prognosis
Size of the Tumor vs Prognosis
Extension of Melanoma
Novel Prognostic Parameters in Uveal Melanoma
Malignant Melanomas of Iris
Microscopic Features
Melanomas of Ciliary Body
Metastatic Tumors
Primary Site of Choroidal Metastasis in Order of Frequency
Medulloepithelioma
Histopathology
Benign
Malignant
Intraocular Lymphoma
PART II:
CHAPTER 8:
Diseases of the Retina
CHAPTER 9:
Coats' Disease
CHAPTER 10:
Disease of the Vitreous
ASTEROID HYALOSIS
VITREOUS AMYLOIDOSIS
CHAPTER 11:
Pathology of the Orbit
DIFFERENT TISSUES WITHIN THE ORBIT
CLASSIFICATION (TABLE 11.1)
ORBITAL INFLAMMATION
A. Acute
B. Chronic
Orbital Cellulites
Causes
PSEUDOTUMOR
Microscopic Examination
THYROID OPHTHALMOPATHY
Microscopic Examination
Vasculitis
Wegener's Granulomatosis
Orbital Tumors
Primary Orbital Tumors
Congenital Tumors
Choristoma
Dermoid
Epidermal Cyst
Hamartoma
Types
Vasculogenic Tumors
Cavernous Hemangioma
Capillary Hemangioma
Micro
Hemangiopericytoma
Micro
Lymphangioma
Gross
Micro
Peripheral Nerve Tumors
Neurofibroma
Neurilemmoma (Schwannoma)
Optic Nerve and Meningeal Tumors
Optic Nerve Glioma
Micro
Optic Nerve Meningioma
Types
Micro
Rhabdomyosarcoma
Micro
Embryonal
Botryoid
Alveolar
Pleomorphic
Treatment
Malignant Lymphoma
Marginal Zone Lymphoma
Small Lymphocytic Lymphoma
Follicular Lymphoma
Burkitt's Lymphoma
Microscopic Examination
Large Cell Lymphoma
Tumors of the Lacrimal Gland
A. Epithelial Tumors
Epithelial Lacrimal Gland Tumors
Orbital Metastasis
Common Primary Sites
Secondary Orbital Tumors
PART III:
CHAPTER 12:
Cytopathology of the Eye
I. IMPRESSION CYTOLOGY
Indications
Procedure
Processing
Interpretation
II. CORNEAL AND CONJUNCTIVAL SCRAPING
Indications
Procedure
Processing
Cytopathological correlation
Conjunctiva
Cornea
III. AQUEOUS TAP
Indications
Procedure
Processing
Interpretation (Figures 12.11 and 12.12 and Table 12.1)
IV. VITREOUS TAP
Indications
Procedure
Processing
Interpretation (Table 12.2)
V. FINE NEEDLE ASPIRATION BIOPSY (FNAB)
Indications
Pars Plana Transvitreal Approach
Corneolimbal Approach
Subretinal FNAB
Complications
Processing
Orbital FNAB
Summary
Applications
Anterior Segment
Cytopathologic Correlation
Atypical epithelial cells
Keratinized epithelium
Special Techniques
Indirect immunofluorescent staining
Imprint smear
Diagnostic Possibilities and Technique of Choice
Cytopathology of Intraocular Fluid/Tissue Specimen
Inflammatory Conditions
Neoplasms
Secondary Glaucoma
Others
Approach
Fine Needle Aspiration Biopsy
Orbit
CHAPTER 13:
Frozen Section
CHAPTER 14:
Ocular Pathology in AIDS
POSTERIOR SEGMENT LESIONS IN AIDS
Retina
Noninfective Vascular Disorders
Opportunistic Infections of the Retina
Bacterial Infections of the Retina
Fungal Infections of the Retina
Protozoal Infections of the Retina
Orbital Involvement
CHAPTER 15:
Telepathology
References
SANKARA NETHRALAYA PUBLICATIONS IN OPHTHALMIC PATHOLOGY
FURTHER READING
INDEX
TOC
Index
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