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Eye pathology (Conjunctiva (Pterygium眼翳病 (組織 (Bowman's layer…

- - - - Positional proptosis: 淚腺變大，把眼睛往內下擠
        
        Inflammation→Sarcoidosis
        
        Asteroid body
        
        Neoplasm: Lymphoma,pleomorphic adenoma(mixed Tumor), adenoids cystic carcinoma)
      - Axial proptosis
        
        Thyroid ophthalmopathy (Grave's dz)
        
        最常見的兩種造成的腫瘤 (Primary tumor of optic nerve)
        
        Glioma
        
        Meningioma
  - - - Orbital cellulitis
      - Mucormycosis 白黴菌病
        
        Most common: Rhinocerebral mucormycosis鼻腦白黴菌病
    - - ANCA-associated small-vessel vasculitis
        
        自體抗體 (proteinase 3)
        
        Positive anti-neutrophil cytoplasm test (c-ANCA)
    - - 發生部位
        
        Lacrimal gland
        
        Sclerosing dacryoadenitis
        
        Extra-ocular muscles
        
        Orbital myositis
        
        Tenon's capsule(包住眼睛的筋膜)
        
        Posterior scleritis
  - - - Non-Hodgkin lymphoma
      - Hodgkin lymphoma
        
        Reed-Sternberg cell
    - - Neuroblastoma
      - Wilms tumor
      - 造成 characteristic periocular ecchymoses眼周瘀斑
    - - Capillary hemangioma
        
        嬰兒、小孩
      - Lymphangioma
      - Encapsulated cavernous hemangioma
        
        成人
    - - Pleomorphic adenoma of the lacrimal gland
      - Dermoid cyst上皮囊腫
      - Neurilemmoma神經鞘瘤
      - Encapsulated cavernous hemangioma
- - - - 惡性、難診斷
        
        樣子很像Chalazion
        
        易轉移
        
        Parotid nodes
        
        Submandibular nodes
        
        死亡率高
      - Pagetoid spread
        
        沿著表皮、真皮交界長
      - Foamy cytoplasm
    - - 最常見眼瞼腫瘤
      - 明顯好發在
        
        下眼瞼
        
        內眼角 (Canthus)
    - - RARE
  - - - Hordeolum (會痛)
    - - Granulomatous response
        
        Lipogranuloma
        
        Chalazion
- - - - Bowman's layer 被破壞→Corneal scar
      - 伴隨 pannus血管翳
      - 慢性發炎
  - - - 可能源自 Intraepithelial changes
    - - Squamous papillomas
      - Conjunctival intraepithelial neoplasia
    - - conjunctival nevi 痣
        
        不太會侵犯到Cornea
      - Conjunctival melanoma
        
        50-90% 未完全治療好的 Primary acquired melanosis with atypia (intraepithelial growth) 會形成
- - - - 細菌
      - 病毒
        
        Herpes simplex
        
        Chronic herpes simplex keratitis
        
        Hallmark: Granulomatous reaction in the Descemet membrane
        
        Herpes zoster
      - 真菌
      - 原蟲 (Acanthamoeba)
- - - - Systemic dz
        
        Galactosemia
        
        DM
        
        Wilson's disease*--Kayser-Fleischer ring*
        
        Atopic dermatitis
      - Drugs
        
        Corticosteroids
      - 其他
        
        Radiation
        
        Trauma
        
        Intraocular disorders
  - - - 原因
        
        Infectious agents (Pneumocystis carinii)
        
        Idiopathic
        
        Sarcoidosis
        
        嚴重併發症
        
        Granulomatous uveitis
        
        區域
        
        2 more items...
        
        病理組織
        
        2 more items...
        
        Autoimmune (sympathetic ophthalmia)
    - - Metastatic
        
        成人最常見的intra-ocular malignancy
        
        存活率低
        
        治療: Radiotherapy (治標不治本)
      - Uveal melanoma
        
        成人最常見 Primary intra-ocular malignancy
        
        經血液轉移，最先到肝臟
        
        組織
        
        Spindle cells
        
        幾乎沒有atypia異型
        
        Epithelioid cells
        
        圓形，較多atypia
        
        依發生區域
        
        Iris
        
        Indolent 較惰性
        
        Ciliary body & Choroid
        
        More aggressive
        
        預後取決於
        
        細胞型態
        
        Proliferative index
        
        大量的Tumor-infiltrating lymphocytes(TILs)
        
        預後最差
        
        Extraocular extension
        
        大小
        
        橫向範圍Lateral extent (不像Cutaneous melanoma取決於深度)
      - Uveal nevi
        
        尤其choroidal nevi相當普遍
        
        不常形成melanoma
- - - - Uveitis
      - Scleritis
  - - - Genetic
        
        Neuronal cell origin
        
        Germline mutation of one RB allele
      - Bilateral retinoblastoma + Pinealoblastoma
        
        Trilateral retinoblastoma
        
        預後極差
      - 最常擴散到腦、骨髓
      - Pre-malignant lesion
        
        Retinocytoma
        
        如果一隻眼睛retinoblastoma然後另一隻眼睛Retinocytom就是遺傳性Retinoblastoma的表現
        
        Retinoma
      - Morphology
        
        遺傳性或自發性的型態相同
        
        undifferentiated + differentiated elements: 分化程度與預後無關
        
        Flexner-Wintersteiner roseetes & Fleurettes
        
        Photoreceptor differentiation
        
        在明顯的lumen中有單層的腫瘤細胞排列
        
        Dystrophic calcification:會出現在tumor necrosis區域