Papillary cystadenoma lacrimal caruncle
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Brit. J. Ophthal. (I969) 53, 34 Papillary cystadenoma of the lacrimal caruncle C. H. GREER Royal Victorian Eye and Ear Hospital, Melbourne, Australia The following case is presented as an additional example of papillary cystadenoma of the lacrimal caruncle. Case report A 68-year-old white woman presented with an irritable and slightly enlarged left,caruncle. What was clinically described as a pedunculated caruncular papilloma was excised and sectioned. Microscopic appearances Sections showed part of a spherical cystadenoma situated immediately beneath the surface epithelium of the caruncle (Fig. I). w ~ ~ ~~~.0i I.I.-A-ti . m FIG. i Low-power view of papillary cystadenoma of the caruncle. Haematoxylin and eosin x i8 The adenoma, which was sharply circumscribed but not encapsulated, consisted in part of radially- orientated, slender, anastomosing papillary processes clothed by double-layered eosinophilic epi- thelium (Fig. 2). The basal cells of this epithelium were polygonal and relatively small with round nuclei, while the surface cells were tall and cylindrical in shape with conspicuous cell boundaries, granular eosinophilic cytoplasm, and oval nuclei Iying near the free borders of the cells (Fig. 3). Received for publication March 21, i968 Address for reprints: Royal Victorian Eye and Ear Hospital, Victoria Parade. East Melbourne, 3002, Australia copyright. on November 24, 2021 by guest. Protected by http://bjo.bmj.com/ Br J Ophthalmol: first published as 10.1136/bjo.53.1.34 on 1 January 1969. Downloaded from
Transcript of Papillary cystadenoma lacrimal caruncle
Brit. J. Ophthal. (I969) 53, 34
Papillary cystadenoma of thelacrimal caruncle
C. H. GREER
Royal Victorian Eye and Ear Hospital, Melbourne, Australia
The following case is presented as an additional example of papillary cystadenoma of thelacrimal caruncle.
Case report
A 68-year-old white woman presented with an irritable and slightly enlarged left,caruncle. Whatwas clinically described as a pedunculated caruncular papilloma was excised and sectioned.
Microscopic appearances Sections showed part of a spherical cystadenoma situated immediatelybeneath the surface epithelium of the caruncle (Fig. I).
w ~ ~ ~~~.0i I.I.-A-ti. mFIG. i Low-power view of papillary cystadenoma of the caruncle. Haematoxylin and eosinx i8
The adenoma, which was sharply circumscribed but not encapsulated, consisted in part of radially-orientated, slender, anastomosing papillary processes clothed by double-layered eosinophilic epi-thelium (Fig. 2). The basal cells of this epithelium were polygonal and relatively small with roundnuclei, while the surface cells were tall and cylindrical in shape with conspicuous cell boundaries,granular eosinophilic cytoplasm, and oval nuclei Iying near the free borders of the cells (Fig. 3).
Received for publication March 21, i968Address for reprints: Royal Victorian Eye and Ear Hospital, Victoria Parade. East Melbourne, 3002, Australia
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Papillary cystadenoma of the lacrimal caruncle
FIG. 2 Higher magnification of the papillary processes, with inconspicuousfibrous tissue cores.
Haematoxylin and eosin x 75
Some of these cells contained mucus. The inconspicuous connective tissue stroma of the growthwas sparsely infiltrated by lymphocytes. Other areas of the adenoma were more compact andexhibited tubules and acini containing blobs of mucus. The tumour had not been completelyremoved.
FIG. 3 Papillary processes clothed by characteristic double-layered epithelium.and eosin x i 8o
Haematoxylin
Comment
The epithelial component of this adenoma is strikingly similar to that seen in adeno-lymphomata of the parotid gland. Adenolymphomata (papillary cystadenoma lympho-matosum, Warthin's tumour) are benign tumours occurring predominantly in the substance
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C. H. Greer
of, or in close relation to, the parotid gland. They are made up of characteristic double-layered eosinophilic epithelium clothing richly cellular lymphoid stroma. Azzopardi andHou (i 964) have provided striking proof of the validity of the prevailing belief that adeno-lymphomata originate from salivary duct epithelium incorporated in lymph nodes adjacentto, or embedded in, the parotid gland.Tumours of identical or very similar structure occasionally arise from minor salivary
glands in the larynx (Heinz, I95I) and oral cavity (Veronesi and Corbetta, 1960;Goldmann, I967; Stuteville and Corley, I967) or from the minor lacrimal glands of thecaruncle (Mackenzie and Patience, 1959; Oaks andJenson, I963; Forbes and Crawford,I963). Coats (I9I2) reported a case which he called spiradenoma papilliferum cysticumon the mistaken assumption that it arose from a sweat gland. In extraparotid cystadeno-mata the characteristic lymphoid stroma may be scanty or absent and the usual fibrouscapsule may be missing. No report of an adenolymphomh of the major lacrimal glandshas yet appeared.
Summary
A papillary cystadenoma of the lacrimal caruncle in a woman aged 68 years is reported.The growth probably originated in accessory lacrimal glands.
References
AZZOPARDI, J. G., and HOU, L. T. (I964) J. Path. Bact., 88, 2I3COATS, G. (I912) Roy. Lond. Hosp. Rep., I8, 269FORBES, G. B., and CRAWFORD, R. A. D. (I963) Brit. J. Ophthal., 47, I77GOLDMAN, R. L. (I967) Amer. J. clin. Path., 48, 49HEINZ, I. (195I) Aust. N.Z. J. Surg., 21, 47MACKENZIE, J. R., and PATIENCE, C. R. (1959) J. Path. Bact., 78, 288OAKS, L. W., and JENSON, M. B. (I963) Amer. J. Ophthal., 56, 459STUTEVILLE, 0. H., and CORLEY, R. D. (I967) Cancer (Philad.), 20, 1578VERONESI, U., and CORBETTA, L. (I960) Acta oto-laryng. (Stockh.), 52, I
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