Roopa Arora

Primary orbital primitive neuroectodermal tumour with immunohistochemical and electron microscopic confirmation

Presentation of two cases of orbital primitive neuroectodermal tumour. Microscopically, the tumours consisted of poorly differentiated cells with dark, oval to irregular nuclei, prominent nucleoli, scant cytoplasm and numerous mitoses. The clinical picture, histopathology, electron microscopy and immunohistochemical findings of these cases are presented in this communication. Also, the histogenesis of such orbital neoplasms in relation to central nervous system is discussed.

Intraocular medullo-epithelioma: Pitfalls in the cytological diagnosis

A case of intraocular malignant medullo-epithelioma in a four-year-old male child is reported. A diagnosis of retinoblastoma was made based on the clinical picture and the cytologic findings of the aqueous aspirate. the histopathology of the enucleated eyeball specimen, however, confirmed the diagnosis of medullo-epithelioma. Difficulties experienced in arriving at an accurate cytological diagnosis of the tumour are highlighted.

Ciliary body medulloepithelioma: An immunohistochemical study

The authors studied paraffin embedded specimens from five surgically enucleated eyes with medulloepithelioma by the peroxidase-anti-peroxidase procedure with antibodies against glial fibrillary acidic protein (GFAP), neurone-specific enolase (NSE), neurofilament triplet polypeptide (NF) and desmin. They found that embryonic medullary epithelium in four cases of benign medulloepithelioma and undifferentiated neuroblastic areas in one case of malignant medulloepithelioma expressed neurone-specific enolase. GFAP detected glial areas in two cases of benign medulloepithelioma, thus classifying them as teratoid variants. Desmin was not detected in any of the neoplasms indicating lack of muscle differentiation. Hence, immunohistochemistry was able to differentiate the various types of medulloepitheliomas.

Aspiration cytology of smooth-muscle tumours of the orbit

A correlative cytologic and histologic study of an orbital leiomyoma and a leiomyosarcoma is presented. Pertinent cytologic features of both tumours as observed in aspiration smears are described. The soft-tissue tumour aspirates were classified according to their cytomor-phology into the benign and the malignant variant. FNA cytology was useful in both the initial diagnosis of a new lesion and in the confirmation of the recurrence. The differential diagnosis between smooth muscle tumours and other spindle-cell soft tissue neoplasms by aspiration cytology is discussed. The final diagnosis of soft-tissue sarcomas should be based on the histologic study of tissue sections.

Fine needle aspiration of paediatric orbital tumours

Fine needle aspiration biopsies (FNAB) were performed for the diagnosis of orbital tumours in 15 children in the age group of one to 15 years. Positive cytology was obtained in 13/15 cases. Inadequate and necrotic material was aspirated in two cases. there were 11 malignant and two benign lesions. Malignant tumours consisted of embryonal rhabdomyosarcoma, retinoblastoma and one case of metastatic neuroblastoma. the two benign lesions were inflammatory pseudotumours. No false-positive diagnosis occurred. the best indication of FNAB was in case of supposed malignant unresectable neoplasms and in metastatic and recurrent orbital tumours.

Fine needle aspiration of adenoid cystic carcinoma of the orbit

Cytologic findings of a case of basaloid (solid) variant of adenoid cystic carcinoma of orbit are described. Based on the cytologic diagnosis, the mass was resected and, later on, confirmed on histopathology. The differential diagnosis of the case as well as the importance of recognizing the solid variant on cytologic smears are discussed.

Nasopharyngeal angiofibroma: An ophthalmic diagnostic problem

Angiofibromas of the nasopharynx are known to have ocular involvement usually as a late manifestation. Absence of nasal symptoms for a considerable period, even up to 6-12 months after the initial ophthalmic complaints, is unusual and has not been reported before in the literature. A series of cases including nasopharyngeal angiofibroma and nasopharyngeal carcinoma are presented. Various ocular manifestations included proptosis, papilloedema, optic atrophy and cranial nerve palsies. Confirmation of diagnosis required a thorough ENT cheekup, like skiagraphy, computerized tomography, carotid angiography and ultrasonography. In two cases of angiofibroma, massive extension of the tumour was noted intracranially without any other obvious neurological or otolaryngological complaints. Other extremely rare features included occurrence of angiofibroma in a 29-year-old female.This communication highlights the importance of such unusual modes of presentation and the necessity of a detailed ENT check-up as well as ot...