Click here to load reader

BAGIAN PATOLOGI ANATOMI - ocw.usu.ac.idocw.usu.ac.id/course/download/1110000121-special-senses-system/s… · BAGIAN PATOLOGI ANATOMI FAKULTAS KEDOKTERAN USU USU –– MEDAN MEDAN

  • View
    229

  • Download
    3

Embed Size (px)

Text of BAGIAN PATOLOGI ANATOMI -...

  • BAGIAN PATOLOGI ANATOMIBAGIAN PATOLOGI ANATOMIFAKULTAS KEDOKTERANFAKULTAS KEDOKTERAN

    USU USU MEDANMEDAN

    20072007

  • NORMAL ANATOMYNORMAL ANATOMY

    PalpebraePalpebraeConjunctivaConjunctivaCorneaCorneaLensLensUvea tractUvea tractRetinaRetinaRetinaRetinaVitreous humorVitreous humorNerveNerveGlandGlandMuscleMuscleBlood vesselsBlood vessels

  • NORMAL ANATOMYNORMAL ANATOMY

    A A -- Vitreous humorVitreous humor

    B B -- LensLens

    C C -- CorneaCornea

    D D -- PupilPupilD D -- PupilPupil

    E E -- IrisIris

    F F -- ScleraSclera

    G G -- Optic NerveOptic Nerve

    H H -- RetinaRetina

  • CHOROIDCHOROID

    CHOROID = MIDDLE CHOROID = MIDDLE LAYER EYE LAYER EYE

    CONTAINS :CONTAINS : CONTAINS :CONTAINS : BLOOD VESSELS &BLOOD VESSELS &

    CONNECTIVE TISSUE CONNECTIVE TISSUE

    SUPPLIES NUTRIENTS SUPPLIES NUTRIENTS TO INNER PORTION OF TO INNER PORTION OF EYEEYE

  • CILIARY BODY CILIARY BODY

    CILIARY BODYCILIARY BODY = ring of = ring of tissue tissue encircles the lens. encircles the lens.

    Contains : Contains : smooth muscle fibers smooth muscle fibers

    (ciliary muscles)(ciliary muscles)

    control the shape of the control the shape of the control the shape of the control the shape of the lens. lens.

    Posterior surface lens Posterior surface lens (CILIARY PROCESSES)(CILIARY PROCESSES)

    Contain : capillaries Contain : capillaries

    Secrete fluid (vitreous Secrete fluid (vitreous humor) humor) into the anterior into the anterior segment of the eyeball. segment of the eyeball.

  • LACRIMAL SYSTEMLACRIMAL SYSTEM

    LARGELY : SEROUS TYPE

    MINOR MUCINOUSMINOR MUCINOUS

  • DISORDER OF EYEDISORDER OF EYE

    MICRO ORGANISMS *MICRO ORGANISMS *

    ANTIGEN *ANTIGEN *

    TOXIC CHEMICAL *TOXIC CHEMICAL *

    SOLAR RADIATION *SOLAR RADIATION * SOLAR RADIATION *SOLAR RADIATION *

    SYSTEMIC DISEASE *SYSTEMIC DISEASE *

    * * BLINDNESSBLINDNESS

  • CONGENITAL ANOMALICONGENITAL ANOMALI

    RARELY : RARELY :

    -- ANOPTHTHALMOSANOPTHTHALMOS

    -- EYES (EYES (--))

    -- MICROPHTHALMOSMICROPHTHALMOS-- MICROPHTHALMOSMICROPHTHALMOS

    -- MEDIAN EYEMEDIAN EYE

    -- HYPOPLASIA EYESHYPOPLASIA EYES

    -- COLOBOMACOLOBOMA

    -- CONGENITAL CATARACTSCONGENITAL CATARACTS

    -- COLOR BLINDCOLOR BLIND

  • COLOBOMACOLOBOMA((Defect in iris)Defect in iris)

    Appear : black notch Appear : black notch pupil : irregular (shape) pupil : irregular (shape) May be associated with :May be associated with :

    Hereditary conditionsHereditary conditions Trauma to the eye, or Trauma to the eye, or Eye surgeryEye surgery

  • CONGENITAL CATARACTSCONGENITAL CATARACTS

    The number of people born with cataracts is low. The number of people born with cataracts is low.

    Possible causes :Possible causes : GalactosemiaGalactosemia Chondrodysplasia syndrome Chondrodysplasia syndrome Congenital Congenital rubellarubella syndrome syndrome Down syndromeDown syndrome (trisomy 21) (trisomy 21) Down syndromeDown syndrome (trisomy 21) (trisomy 21) PierrePierre--Robin syndrome Robin syndrome Familial congenital cataracts Familial congenital cataracts HallermanHallerman--Streiff syndrome Streiff syndrome Lowe syndrome Lowe syndrome Trisomy 13Trisomy 13 Conradi syndrome Conradi syndrome Ectodermal dysplasiaEctodermal dysplasia syndrome syndrome MarinescoMarinesco--Sjogren syndrome Sjogren syndrome

  • CONGENITAL CATARACTS CONGENITAL CATARACTS

  • PIGMENTATIONPIGMENTATION

    EXOGENEXOGEN ENDOGENENDOGEN

    MELANINMELANINIRONIRON

    ALBUMIN ALBUMIN MELANOSISMELANOSIS

    MELANINMELANIN

    HEMOSIDERINE HEMOSIDERINE

    I.O.HI.O.H

    IRONIRONCOPPER COPPER SILVERSILVER

  • PIGMENTATIONPIGMENTATION

    KAYSER KAYSER -- FLEISCHER RINGFLEISCHER RINGWILSONS DISEASE (HEPATOLENTIWILSONS DISEASE (HEPATOLENTI

    CULAR DEGENERATION)CULAR DEGENERATION)

    DEPIGMENTATIONDEPIGMENTATION

    VITILIGOVITILIGO

  • PHYSICAL & CHEMICAL INJURIESPHYSICAL & CHEMICAL INJURIES

    TRAUMA :TRAUMA : ECCHYMOSISECCHYMOSIS

    SUP.FICIAL :SUP.FICIAL :

    CONTACT LENSCONTACT LENS CONTACT LENSCONTACT LENS

    FOREIGN BODIESFOREIGN BODIES

    ULTRA VIOLETULTRA VIOLET

    CAUSTIC CHEMICALCAUSTIC CHEMICAL

    BLUNT TRAUMA BLUNT TRAUMA FRACTURE OF BONE FRACTURE OF BONE

  • SKIN APPENDAGES OF EYELIDSSKIN APPENDAGES OF EYELIDS

    1.1. SEBACEOUS GLANDS SEBACEOUS GLANDS (ZEIS & MEIBOMIAN)(ZEIS & MEIBOMIAN)

    2.2. APOCRINE GLANDS APOCRINE GLANDS (MOLL)(MOLL)

    3.3. ECCRINE SWEAT ECCRINE SWEAT GLANDSGLANDS

  • MOLUSCUM CONTANGIOSUMMOLUSCUM CONTANGIOSUM

    VIRAL INFECT VIRAL INFECT WART LIKEWART LIKE

    CENTRAL UMBILICAL CENTRAL UMBILICAL KERATINKERATIN

    CYSTIC LESSIONCYSTIC LESSIONCYSTIC LESSIONCYSTIC LESSION

    SUDORIFERASUDORIFERA

    SEBACEASEBACEA

    MEIBOMIANMEIBOMIAN

    DERMOIDDERMOID

  • HORDEOLUMHORDEOLUM

    ( = STYE )( = STYE )

    ZEIS GLAND (SEBACEOUS GLANDS)ZEIS GLAND (SEBACEOUS GLANDS)

    EXTERNAL HORDEOLUMEXTERNAL HORDEOLUM

    MEIBOMIAN GLANDS MEIBOMIAN GLANDS INTERNAL INTERNAL MEIBOMIAN GLANDS MEIBOMIAN GLANDS INTERNAL INTERNAL HORDEOLUMHORDEOLUM

    FOLICLE FOLICLE

    INFECTION STAPHYLLOCOCUS INFECTION STAPHYLLOCOCUS CELLULITISCELLULITIS

  • HORDEOLUMHORDEOLUM

    EXTERNAL

    INTERNAL

  • CHALAZIONCHALAZION

    (MEIBOMIAN GLAND LIPOGRANULOMA)(MEIBOMIAN GLAND LIPOGRANULOMA)

    A PAINLESS GRANULOMA A PAINLESS GRANULOMA OF THE MEIBOMIAN OF THE MEIBOMIAN GLANDS GLANDS

    MEIBOMIAN GLAND MEIBOMIAN GLAND OCCLUTIONOCCLUTION

    CHRONIC CHRONIC GRANULATIONGRANULATIONGRANULATIONGRANULATION

  • MICROSCOPIC MICROSCOPIC

    MULTIPLE FOCI OF GRANULOMATOUS INFLAMMATIONMULTIPLE FOCI OF GRANULOMATOUS INFLAMMATION

  • XANTHELASMA XANTHELASMA

    SHARPLY DEMARCATED YELLOWISH SHARPLY DEMARCATED YELLOWISH (COLLECTION CHOLESTEROL) (COLLECTION CHOLESTEROL) --UNDERNEATH SKINUNDERNEATH SKIN

    USUALLY : ON / AROUND EYELIDSUSUALLY : ON / AROUND EYELIDS USUALLY : ON / AROUND EYELIDSUSUALLY : ON / AROUND EYELIDS

    ASSOCIATIONS :ASSOCIATIONS : CHOLESTEROL CHOLESTEROL (FAMILIAL HYPERCHOL) (FAMILIAL HYPERCHOL)

    PRIMARY BILIARY CIRRHOSIS PRIMARY BILIARY CIRRHOSIS MENOPAUSE MENOPAUSE DIABETES DIABETES

  • EXOPTHALMUSEXOPTHALMUS

    ( = PROPTOSIS )( = PROPTOSIS )

    PROTUSION (EYEBALL)PROTUSION (EYEBALL)

    BILATERALBILATERAL

    THYROID DISEASETHYROID DISEASETHYROID DISEASETHYROID DISEASE

    EARLY ADULT LIFE (WOMEN), 4/1EARLY ADULT LIFE (WOMEN), 4/1

    + EDEMA (EYELID, CHEMOSIS)+ EDEMA (EYELID, CHEMOSIS)

  • EXOPTHALMUSEXOPTHALMUS

    ( = PROPTOSIS )( = PROPTOSIS )

    PATHOLOGY:PATHOLOGY:

    ORBITAL WATER >>ORBITAL WATER >>

    EXT.OCULAR MUSCLE >>EXT.OCULAR MUSCLE >>

    ( + LYMPHOCYTES & MN )( + LYMPHOCYTES & MN )( + LYMPHOCYTES & MN )( + LYMPHOCYTES & MN )

    CLINIC : CLINIC :

    EXPOSURE CONJTIVA EXPOSURE CONJTIVA BLIDING, BLIDING,

    ULCERATION, OPTIC NERVE ULCERATION, OPTIC NERVE COMPRESSIONCOMPRESSION

  • CONJUNCTIVA DISORDERCONJUNCTIVA DISORDER

    HYPEREMIAHYPEREMIA

    HEMORRHAGEHEMORRHAGE

    INFLAMATIONINFLAMATION

    THRACHOMATHRACHOMA THRACHOMATHRACHOMA

    CHLAMYDIAL INFECTIONCHLAMYDIAL INFECTION

    OPHTHALMIA NEONATORUMOPHTHALMIA NEONATORUM

    DRYDRY--EYE SYNDROMEEYE SYNDROME

    PINGUECULA & PTERYGIUMPINGUECULA & PTERYGIUM

  • HYPEREMIA HYPEREMIA -- CONJUCTIVACONJUCTIVA

    DILATASI BLOOD VESELDILATASI BLOOD VESEL

    CONJUNCTIVITISCONJUNCTIVITIS

    CORNEA DISEASECORNEA DISEASE

    IRIDOCYCLITISIRIDOCYCLITIS IRIDOCYCLITISIRIDOCYCLITIS

    CORNEA DEFECTCORNEA DEFECT

    GLAUCOMAGLAUCOMA

    IRITISIRITIS

  • HEMORRHAGE CONJUNCTIVAHEMORRHAGE CONJUNCTIVA

    TRAUMATRAUMA

    ANOXIAANOXIA

    SEVERE COUCHING SEVERE COUCHING SPONTANEUSSPONTANEUS SEVERE COUCHING SEVERE COUCHING SPONTANEUSSPONTANEUS

  • SUBCONJUNCTIVAL HEMORRHAGE SUBCONJUNCTIVAL HEMORRHAGE

    Causes :Causes :

    Minor eye trauma Minor eye trauma Spontaneously (venous Spontaneously (venous

    press press ))

    Streneuous Exercising Streneuous Exercising Streneuous Exercising Streneuous Exercising Coughing Coughing Touching/widening eyes Touching/widening eyes Sneezing Sneezing Vomiting (bulimia nervosa) Vomiting (bulimia nervosa) Severe alcohol intoxication, Severe alcohol intoxication,

    blood press blood press

    Severe hypertension Severe hypertension

  • CONJUNCTIVITISCONJUNCTIVITIS

    MICROMICRO--ORG ORG CONJUNCTIVITISCONJUNCTIVITIS

    KERATITISKERATITIS

    CORNEAL ULCERCORNEAL ULCER

    HEMATOGEN HEMATOGEN HEMATOGEN HEMATOGEN

    IATROGENIC INFECTIONIATROGENIC INFECTION

    SURGICAL : SURGICAL :

    CATARACTCATARACT

    CORNEAL GRAFTCORNEAL GRAFT

    PROSTHETIC LENSPROSTHETIC LENS

  • CONJUNCTIVITISCONJUNCTIVITIS

    EXUDATE/DISCHARGE :EXUDATE/DISCHARGE :

    -- PURULENT PURULENT CLOSECLOSE

    -- FIBRINOUSFIBRINOUS-- FIBRINOUSFIBRINOUS

    -- SEROUSSEROUS

    -- HEMORRHAGICHEMORRHAGIC

  • CONJUNCTIVITISCONJUNCTIVITIS

  • TRACHOMATRACHOMA

    INF.CHRONIC (CLAMYDIA TRACHOMATIS)INF.CHRONIC (CLAMYDIA TRACHOMATIS)

    = SWIMMING POOL CONJUNCTIVITIS= SWIMMING POOL CONJUNCTIVITIS

    OCULAR, GENITAL, SYSTMICOCULAR, GENITAL, SYSTMIC

    BLIND BLIND BLIND BLIND

    CHILD CHILD REMISION (SP) REMISION (SP)

    ADULT ADULT PROGRESSIVEPROGRESSIVE

    BILATERAL, SUP > INF BILATERAL, SUP > INF

  • NEW BORN :NEW BORN : PURULENT CONJUNC. PURULENT CONJUNC. (BLENORRHOE)(BLENORRHOE)

    ADULT :ADULT : CHRONIC FOLLICLE CONJ. CHRONIC FOLLICLE CONJ.

    LYMPHOCYTE (+)LYMPHOCYTE (+)

    HYPERPLASIA HYPERPLASIA GERM. CENTRE NECROTIC GERM. CENTRE NECROTIC

    TRACHOMATOUS PANNUSTRACHOMATOUS PANNUS

    (EPIT (EPIT BOWMANN ZONE)BOWMANN ZONE) FIBROSIS (CONJ. & EYELIDS) FIBROSIS (CONJ. & EYELIDS)

    DISTORS EYELIDSDISTORS EYELIDS

    PATHOLOGY : PATHOLOGY :

    LOWER TARSAL CONJUNTIVALOWER TARSAL CONJUNTIVA

    SCAR & NECROTIC (SCAR & NECROTIC (--))

    KERATITIS (KERATITIS (--))

  • TRACHOMATRACHOMA(CHLAMYDIAL CONJUNCTIVITIS)(CHLAMYDIAL CONJUNCTIVITIS)

  • OPHTHALMIA NEONATORUMOPHTHALMIA NEONATORUM

    ACUTE ACUTE SEVERE CONJUNCTIVITISSEVERE CONJUNCTIVITIS

    COPIUS PURULENT DISCHARGECOPIUS PURULENT DISCHARGE

    GO GO GOGO--NEONATORUMNEONATORUM

    ULC.CORNEA, PERFORATION ULC.CORNEA, PERFORATION ULC.CORNEA, PERFORATION ULC.CORNEA, PERFORATION

    SCAR & PANOPHITIS SCAR & PANOPHITIS BLIND BLIND PREVENT PREVENT SILVER NITRAT (PNC)SILVER NITRAT (PNC)

  • OPTHALMIA NEONATORIUMOPTHALMIA NEONATORIUM

    Microbial Agent : Neisseria gonorrhoeae Mode of Transmission: From mother to

    newborn Classic Feature: purulent destructive

    eye disease

  • DRY EYE SYNDROMEDRY EYE SYNDROME

    Common condition Common condition

    Tear production

  • Common causes :Common causes : AgingAging Dry environment or workplace (wind, air Dry environment or workplace (wind, air

    conditioning) conditioning) Sun exposure Sun exposure Smoking / smoke exposure Smoking / smoke exposure Cold / allergy medicines Cold / allergy medicines Sjogren's syndrome Sjogren's syndrome

    includes dry eyes, mouth & mucus includes dry eyes, mouth & mucus membranesmembranesmembranesmembranes often RA / other joint disorderoften RA / other joint disorder

    The result of :The result of : Sensitivity of the cornea Sensitivity of the cornea Evaporation of tears Evaporation of tears

    Disorder in the glands Disorder in the glands

  • PINGUECULAPINGUECULA

    LUMP LUMP YELLOWISHYELLOWISH

    NASAL TO THE CORNEOSCLERALNASAL TO THE CORNEOSCLERAL

    SUN DAMAGED SUN DAMAGED INJURYINJURY SUN DAMAGED SUN DAMAGED INJURYINJURY

    DOES NOT GROW ONTO CORNEA

    DEPOSIT OF PROTEIN & FAT

    PARTICULARLY OLDER PEOPLE

  • PINGUECULAPINGUECULA

  • PTERYGIUM

    FOLD OF VASCULARIZED FOLD OF VASCULARIZED RECURS AFTER EXISION RECURS AFTER EXISION (PINGUECULA)(PINGUECULA)

    GROWS : TRIANGULAR SHAPE OVER THE CORNEA (THE TRANSPARENT PART OR FRONT WINDOW OF THE EYEBALL).

    MAY GROW LARGE ENOUGH TO INTERFERE WITH VISION

    COMMONLY : INNER CORNER OF THE EYE (APEX PUPIL)

  • PTERYGIUM

  • CLOUDY CORNEA CLOUDY CORNEA

    CORNEA : TRANSPARENT CORNEA : TRANSPARENT STRUCTURE STRUCTURE

    LESS TRANSPARENT & LESS TRANSPARENT & CLOUDY :CLOUDY : METABOLIC DISEASESMETABOLIC DISEASES TRAUMATRAUMA TRAUMATRAUMA INFECTIOUS DISEASESINFECTIOUS DISEASES NUTRITIONAL NUTRITIONAL

    DEFICIENCIES &DEFICIENCIES & ENVIRONMENTAL ENVIRONMENTAL

    IT CAN LEAD TO VARIOUS IT CAN LEAD TO VARIOUS DEGREES OF VISION DEGREES OF VISION LOSS. LOSS.

  • CORNEACORNEA

    HERPES SIMPLEXHERPES SIMPLEX

    ONCHOCERCIASISONCHOCERCIASIS

    ARCUS SENILISARCUS SENILIS

    BAND KERATOPATHYBAND KERATOPATHY BAND KERATOPATHYBAND KERATOPATHY

    CORNEAL DYSTROPHIESCORNEAL DYSTROPHIES

  • HERPES KERATITISHERPES KERATITIS

  • HYPEREMIAHYPEREMIA

    (TRAUMA)(TRAUMA)

  • EYE LENS ANATOMY EYE LENS ANATOMY

    THE LENS OF THE EYE IS NORMALLY CLEAR.

  • LENSLENS

    CATARACTCATARACT

    PRESBYOPIAPRESBYOPIA

    PHACO ANAPHYLACTIC PHACO ANAPHYLACTIC ENDOPHTHALMITISENDOPHTHALMITISENDOPHTHALMITISENDOPHTHALMITIS

  • CATARACTCATARACT

    THE LENS OF THE EYE IS NORMALLY CLEAR. IF THE LENS BECOMES CLOUDY OR IS OPACIFIED IT IS CALLED A CATARACT

  • NORMAL, NEAR &

    FARSIGHTEDNESS

  • UVEAUVEA

    SYMPATHETIC OPHTHALMITISSYMPATHETIC OPHTHALMITIS

    SARCOIDOSISSARCOIDOSIS

  • RETINARETINA

    HEMORRHAGEHEMORRHAGE

    OCCLUSIVE VASC.DISEASEOCCLUSIVE VASC.DISEASE

    -- CENTRAL R. ART.OCCLUSIONCENTRAL R. ART.OCCLUSION

    -- CENTRAL R. VEIN OCCLUSIONCENTRAL R. VEIN OCCLUSION-- CENTRAL R. VEIN OCCLUSIONCENTRAL R. VEIN OCCLUSION

    HYPERTENSIVE RETINOPATHYHYPERTENSIVE RETINOPATHY

    DIABETIC RETINOPATHYDIABETIC RETINOPATHY

    RETINAL DETACHMENT RETINAL DETACHMENT

  • RETINARETINA

    RETINITIS PIGMENTOSARETINITIS PIGMENTOSA

    MACULAR DEGENERATIONMACULAR DEGENERATION

    CHERRYCHERRY--RED SPOT AT THE MACULARED SPOT AT THE MACULA

    ANGIOID STREAKSANGIOID STREAKS ANGIOID STREAKSANGIOID STREAKS

    RETINOPATHY OF PREMATURITYRETINOPATHY OF PREMATURITY

  • OPTIC NERVEOPTIC NERVE

    OPTIC NERVE HEAD EDEMAOPTIC NERVE HEAD EDEMA

    OPTIC ATROPHYOPTIC ATROPHY

  • EFFECTS OF INCREASE EFFECTS OF INCREASE

    INTRAOCULAR PRESSUREINTRAOCULAR PRESSURE

    GLAUCOMAGLAUCOMA

    CORNEA/SCLERA CORNEA/SCLERA BULGESBULGESBULGESBULGES

    OPTIC ATROPHYOPTIC ATROPHY

  • GLAUCOMA GLAUCOMA

    Increased pressure Increased pressure causes compression of :causes compression of :

    Retina and Retina and

    GLAUCOMA IS A CONDITION OF INCREASED GLAUCOMA IS A CONDITION OF INCREASED FLUID PRESSURE INSIDE THE EYE.FLUID PRESSURE INSIDE THE EYE.

    Retina and Retina and

    Optic nerve Optic nerve NNerve erve damage. damage.

    Glaucoma can cause :Glaucoma can cause : Partial vision loss, Partial vision loss,

    Blindness as a possible Blindness as a possible eventual outcome. eventual outcome.

  • GLAUCOMAGLAUCOMA

    CONGENITAL GLAUCOMACONGENITAL GLAUCOMA

    INFANTILE GLAUCOMA, INFANTILE GLAUCOMA, BUPHTHALMOSBUPHTHALMOS

    PRIMARY OPENPRIMARY OPEN--ANGLE GLAUCOMAANGLE GLAUCOMA PRIMARY OPENPRIMARY OPEN--ANGLE GLAUCOMAANGLE GLAUCOMA

    PRIMARY CLOSEDPRIMARY CLOSED--ANGLE GLAUCOMAANGLE GLAUCOMA

    SECONDARY GLAUCOMASECONDARY GLAUCOMA

    LOWLOW--TENSION GLAUCOMATENSION GLAUCOMA

  • GLAUCOMAGLAUCOMA

  • NEOPLASMANEOPLASMA

    XANTHELASMAXANTHELASMA

    NEUROFIBROMANEUROFIBROMA

    BENIGNBENIGN MALIGNANTMALIGNANT

    BOWEN DISEASEBOWEN DISEASE

    SQ.CELL.CASQ.CELL.CA NEUROFIBROMANEUROFIBROMA

    PAPILLOMAPAPILLOMA

    LIPOMALIPOMA

    HEMANGIOMAHEMANGIOMA

    LIMPHANGIOMALIMPHANGIOMA

    NEVUSNEVUS

    SQ.CELL.CASQ.CELL.CA

    BASAL CELL CABASAL CELL CA

    MALIG. MELANOMAMALIG. MELANOMA

    AD. CARCINOMAAD. CARCINOMA

    SARCOMASARCOMA

    LYMPHOMALYMPHOMA

  • XANTHELASMAXANTHELASMA

    HYPERCHOLESTEROLEMIA HYPERCHOLESTEROLEMIA DMDM

    REPRODUCTION WOMANREPRODUCTION WOMAN

    LOC : LOC : CANTUS INTERNAL CANTUS INTERNAL PALPAL

    PEBRAE XANTHELASMAPEBRAE XANTHELASMAPEBRAE XANTHELASMAPEBRAE XANTHELASMA

    FOAMY CELLS FOAMY CELLS MICRO INTRA CYTOMICRO INTRA CYTO

    PLASMA VACUOLE.PLASMA VACUOLE.

  • NEUROFIBROMANEUROFIBROMA

    SINGLE OR MULTIPLE SINGLE OR MULTIPLE

    NEUROFIBRONEUROFIBRO

    MATOSIS (VON RECKING MATOSIS (VON RECKING HAUSEN.D)HAUSEN.D)HAUSEN.D)HAUSEN.D)

    LOC. LOC. PALPEBRAEPALPEBRAE

    OTHER SITE (+)OTHER SITE (+)

  • PAPILLOMAPAPILLOMA

    STOLK (+) STOLK (+)

    SQ.EPITH.CELL SQ.EPITH.CELL PROLIFERATIONPROLIFERATION

  • LYMPHANGIOMALYMPHANGIOMA

    LESS COMMONLESS COMMON

    LYMPH VESSELLYMPH VESSEL

    PROLIFERATION PROLIFERATION PROLIFERATION PROLIFERATION

    LUMPLUMP

  • NEVUSNEVUS

    EPITHELIAL CELLSEPITHELIAL CELLS

    NEVI CELLSNEVI CELLS

    TYPETYPE : : -- INTRA DERMALINTRA DERMAL

    -- JUNCTIONALJUNCTIONAL-- JUNCTIONALJUNCTIONAL

    -- COMPOUNDCOMPOUND

  • BOWEN DIASEASEBOWEN DIASEASE

    INTRA EPITHELIAL NEOPLASMINTRA EPITHELIAL NEOPLASM

    CA INSITUCA INSITU

    ATIPICAL CELLSATIPICAL CELLS

    PLEOMORFISMPLEOMORFISM PLEOMORFISMPLEOMORFISM

    UNCOMMONUNCOMMON

  • SQUAMOUS CELL CASQUAMOUS CELL CA

    EPITHELIAL CELLSEPITHELIAL CELLS

    FORM : FORM : -- NON KERATINIZINGNON KERATINIZING

    -- KERATINIZINGKERATINIZING

    PLEOMORFISM CELLSPLEOMORFISM CELLS PLEOMORFISM CELLSPLEOMORFISM CELLS

    HYPERCHROMATIC NUCLEUSHYPERCHROMATIC NUCLEUS

    KERATIN (+/KERATIN (+/--) )

  • BASAL CELL CABASAL CELL CA

    BASAL CELLSBASAL CELLS

    MONOTONMONOTON

    NUCLEUS NUCLEUS BASOPHYLICBASOPHYLIC

    STRANDSTRAND STRANDSTRAND

    PALISADE (+)PALISADE (+)

  • MALIGNANT MELANOMAMALIGNANT MELANOMA

    UVEAL MELANOMAUVEAL MELANOMA

    MELANOCYTE OR NEVI CELLSMELANOCYTE OR NEVI CELLS

    CHOROID (COMMON SITE)CHOROID (COMMON SITE)

    TYPE : MELANOCYTE/AMELANOCYTETYPE : MELANOCYTE/AMELANOCYTE TYPE : MELANOCYTE/AMELANOCYTETYPE : MELANOCYTE/AMELANOCYTE

    MACRMACR : : -- CIRCUMSCRIBEDCIRCUMSCRIBED

    -- INV.BRUCHS MEMBRANEINV.BRUCHS MEMBRANE

    MICRMICR : : -- SPINDLE CELLS SPINDLE CELLS

    -- POLYGONAL CELLSPOLYGONAL CELLS

    -- EPITHELOID CELLSEPITHELOID CELLS

  • ADENO CARCINOMAADENO CARCINOMA

    GLAND PATERNGLAND PATERN

    UNCOMMONUNCOMMON

    DIFFERENTIATED :DIFFERENTIATED :

    -- WELLWELL-- WELLWELL

    -- MODERATEMODERATE

    -- POORLYPOORLY

  • SARCOMASARCOMA

    CONNECTIVE TISSUECONNECTIVE TISSUE

    RHABDO/LEIOMYO SARHABDO/LEIOMYO SA

    FIBRO SAFIBRO SA

    LIPO SALIPO SA LIPO SALIPO SA

  • LYMPHOMALYMPHOMA

    LYMPHOID TISSUELYMPHOID TISSUE

    ROUND CELLSROUND CELLS

    MONOTONEMONOTONE

    TYPETYPE : : -- IMMATURE CELLSIMMATURE CELLS TYPETYPE : : -- IMMATURE CELLSIMMATURE CELLS

    -- MATURE CELLS MATURE CELLS

  • RETINOBLASTOMARETINOBLASTOMA

    IMMATURE CELLSIMMATURE CELLS

    CHILD ( >> )CHILD ( >> )

    FIRST 2 YRS OF LIFE FIRST 2 YRS OF LIFE

    BIRTH ( +/BIRTH ( +/-- )) BIRTH ( +/BIRTH ( +/-- ))

  • RETINOBLASTOMARETINOBLASTOMA

    PATHPATH : : -- INTERNAL INTERNAL VITR.BODYVITR.BODY

    -- EXTERNALEXTERNAL

    CREAM COLOREDCREAM COLORED

    CALCIFIED CALCIFIED YELLOWYELLOWCALCIFIED CALCIFIED YELLOWYELLOW

    MICRMICR : : -- SMALL CELLSSMALL CELLS

    -- ROUND CELLSROUND CELLS

    -- ROSET (+)ROSET (+)

    -- NECROSISNECROSIS

    -- HEMORRHAGIC HEMORRHAGIC

  • RETINOBLASTOMARETINOBLASTOMA

    EARLY DIAG EARLY DIAG OPERATIVEOPERATIVE

    SURVIVAL ( 90 % )SURVIVAL ( 90 % )

    UNTREATED UNTREATED FATALFATAL

    INCIDENT 1/20000 (BIRTH)INCIDENT 1/20000 (BIRTH) INCIDENT 1/20000 (BIRTH)INCIDENT 1/20000 (BIRTH)

    FAMILIAL ( 5 FAMILIAL ( 5 10 % )10 % )

    CHROMOSOME 13 (CHROMOSOME 13 (--) ) Q 14 BANDQ 14 BAND

  • RETINOBLASTOMARETINOBLASTOMA

    CLINICCLINIC: :

    WHITE PUPILS ( LEUCORIA)WHITE PUPILS ( LEUCORIA)

    POOR VISIONPOOR VISION

    HYPEMIAHYPEMIA HYPEMIAHYPEMIA

    STARBISMUSSTARBISMUS

    REDRED

    PAINFUL EYEPAINFUL EYE

  • INTRAOCULAR PHOTOGRAPH OF AN INTRAOCULAR PHOTOGRAPH OF AN

    ISOLATED ISOLATED

    "ENDOPHYTIC" RETINOBLASTOMA"ENDOPHYTIC" RETINOBLASTOMA

  • GLIOMA NERVE OPTICUSGLIOMA NERVE OPTICUS

    UNCOMMONUNCOMMON

    CHILD AND ADULTCHILD AND ADULT

    NEUROFIBROMATOSIS NEUROFIBROMATOSIS GLIOMAGLIOMA

    VISION VISION

  • METASTATIC NEOPLASMMETASTATIC NEOPLASM

    MORE COMMON X PRIMERMORE COMMON X PRIMER

    PRIMER LESSION :PRIMER LESSION :

    -- LEUKEMIALEUKEMIA

    -- BREAST CABREAST CA-- BREAST CABREAST CA

    -- LUNG CALUNG CA

    DIAG : DIAG : AFTER DEATHAFTER DEATH