Krishna R. Surapaneni

Studies on the Histopathology of Temporal Arteritis

Aims: The aim of this paper was to identify the location and to grade the severity of most significant inflammation within positive temporal artery biopsies along with other key clinical and histologic characteristics. Methods: Charts and pathology slides for 70 patients diagnosed with temporal arteritis at the University of Wisconsin (UW) Hospital and Clinics from 1989 to 2015 were reviewed. A subset of 48 specimens was immunostained for CD68 and graded on a scale from 0 to +++; the location of staining was recorded. Results: The most severe granulomatous inflammation was in the media and adventitia in 13% (9/70) of the biopsies; the remaining had uniform full thickness inflammation. Of the slides that were stained with CD68, 94% (45/48) were positive. In 42% (19/45), the stained cells were found mainly in the muscularis and adventitia. Seven percent (3/45) of the slides had staining solely around the internal elastic lamina, and 2% (1/45) had staining limited to the intima. Conclusions: With a few exceptions, granulomatous inflammation in positive temporal artery biopsies is most evident at the media and adventitia or is uniform throughout the layers of the artery. Our study lends support to the theory that the muscularis and adventitia may play an inciting role in the pathogenesis of temporal arteritis.

The Significance of the Discordant Occurrence of Lens Tumors in Humans versus Other Species

PURPOSE The purpose of this study was to determine in which species and under what conditions lens tumors occur. DESIGN A review of databases of available human and veterinary ocular pathologic material and the previously reported literature. PARTICIPANTS Approximately 18 000 patients who had ocular surgical specimens submitted and studied at the University of Wisconsin School of Medicine and Public Health between 1920 and 2014 and 45 000 ocular veterinary cases from the Comparative Ocular Pathology Laboratory of Wisconsin between 1983 and 2014. METHODS Material in 2 major archived collections at the University of Wisconsin medical and veterinary schools were studied for occurrence of lens tumors. Tumor was defined as a new growth of tissue characterized by progressive, uncontrolled proliferation of cells. In addition, cases presented at 3 major eye pathologic societies (Verhoeff-Zimmerman Ophthalmic Pathology Society, Eastern Ophthalmic Pathology Society, and The Armed Forces Institute of Pathology Ophthalmic Alumni Society) from 1975 through 2014 were reviewed. Finally, a careful search of the literature was carried out. Approval from the institutional review board to carry out this study was obtained. MAIN OUTCOME MEASURES The presence of tumors of the lens. RESULTS The database search and literature review failed to find an example of a lens tumor in humans. In contrast, examples of naturally occurring lens tumors were found in cats, dogs, rabbits, and birds. In the veterinary school database, 4.5% of feline intraocular and adnexal neoplasms (234/5153) were designated as feline ocular posttraumatic sarcoma, a tumor previously demonstrated to be of lens epithelial origin. Similar tumors were seen in rabbit eyes, a bird, and in a dog. All 4 species with lens tumors had a history of either ocular trauma or protracted uveitis. The literature search also revealed cases where lens tumors were induced in zebrafish, rainbow trout, hamsters, and mice by carcinogenic agents (methylcholanthrene, thioacetamide), oncogenic viruses (SV40, HPV-16), and genetic manipulation. CONCLUSIONS Our results suggest that lens tumors do not occur in humans. In contrast, after lens capsule rupture, a lens tumor can occur in other species. We hypothesize that a genetic mechanism exists that prevents lens tumors in humans.

Conjunctival Intraepithelial Neoplasia

Originally received: August 18, 2014. Final revision: November 24, 2014. Accepted: December 4, 2014. Available online: December 20, 2014. Manuscript no. 2014-1334. Department of Ophthalmology, Lund University, Skåne University Hospital, Malmö, Sweden. Financial Disclosure(s): The author(s) have made the following disclosure(s): B.B.: Consultant e Carl Zeiss Meditec. A.H.: Consultant e Carl Zeiss Meditec, Allergan, Alcon; Speakers Bureau e Allergan, Santen, MSD; received royalties and payment for the development of educational presentations for Carl Zeiss Meditec and Allergan. Supported by the Herman Järnhardt Foundation, Malmö; the Foundation for Visually Impaired in Former Malmöhus County, Malmö; Crown Princess Margareta’s Foundation, Stockholm; and Skåne County Council’s Research