PubMed Health⌕ Search

Biomedical subjects

A A Hidayat

Publications and source records attributed to A A Hidayat.

50 records · Page 3Linked to original sources

Necrotizing scleritis. A clinico-pathologic study of 41 cases.

Scleritis is not a single clinical or pathologic entity. It has several distinct forms. A clinico-pathologic study of 41 cases of necrotizing scleritis suggests that these different histopathologic forms of disease may reflect different mechanisms of immunopathogenesis. These cases were divided into three main groups: (1) scleral inflammations associated with various systemic autoimmune diseases, including 11 cases of rheumatoid arthritis, three cases of Wegener's granulomatosis, one case of polychondritis, and one case of Goodpasture's syndrome; (2) infectious scleritis, consisting of four cases of herpes zoster ophthalmicus and two cases of pseudomonas scleritis; and (3) idiopathic scleritis, without evidence of systematic disorder, consisting of 19 cases. The first group exhibited predominantly necrosis of the sclera surrounded by granulomatous inflammation and vasculitis. None of these cases showed lymphoid follicles, or healing attempts manifested by proliferation of fibroblasts and blood vessels at the site of inflammation. The idiopathic group revealed few small foci of scleral necrosis and mainly non-granulomatous inflammation. In addition, there was evidence of proliferation of granulation tissue and lymphoid follicles in this group of eyes.

Adult↗

Malignant teratoid medulloepithelioma manifesting as a black epibulbar mass with expulsive hemorrhage.

An 18-year-old woman with malignant teratoid medulloepithelioma had an epibulbar, brown-black mass associated with expulsive hemorrhage and a limboscleral perforation. Histopathologically, a prominent pigmented neuroepithelial component was present and correlated to the black color of the mass. The massive hemorrhage is apparently related to rupture of necrotic and abnormal vascular channels within the angiomatous component of the neoplasm. Other mesenchymal elements included spindle-shaped cells, rhabdomyoblasts, and islands of hyaline cartilage.

Adolescent↗

Juvenile fibrosarcoma of the orbit and eyelid. A study of five cases.

Five patients had juvenile fibrosarcoma of the orbit and eyelid. At initial surgical intervention, the patients ranged in age from newborn to 8 years (mean, 3 years 9 months). Three patients were male and two were female. Proptosis and/or painless swelling of the eyelid were the most common signs and symptoms. Four tumors grew within a few weeks or months, and all five were poorly circumscribed. They were composed of immature, spindle-shaped fibroblastic cells in a classic herringbone pattern or in interlacing fascicles. Hypercellularity and mitotic activity were present in all lesions. The differential diagnosis included rhabdomyosarcoma, fibromatosis, and fibrous histiocytoma. Electron microscopy confirmed the fibroblastic nature of the tumor cells in three cases. Follow-up ranged from one to 32 years (median, seven years). Two of five tumors recurred locally but none metastasized. Apparently surgical excision is the treatment of choice and the tumor has a favorable prognosis.

Child↗

Angiolymphoid hyperplasia with eosinophilia (Kimura's disease) of the orbit and ocular adnexa.

We conducted a clinicopathologic study of eight cases of angiolymphoid hyperplasia with eosinophilia (Kimura's disease). The orbit was involved in five patients and the ocular adnexa (eyelid and inner canthus) in three. The median age of the six men and two women was 51 years (range, 38 to 72 years). The lesions were characterized by an abnormal proliferation of small vessels lined by plump endothelial cells, associated with a chronic inflammatory infiltrate with prominent tissue eosinophilia and scattered lymphoid follicles. Serial sectioning of two tumors disclosed that these small vessels apparently originated within the walls of arteries. Immunohistochemistry disclosed factor VIII-related antigen within the endothelial cells in two of the four lesions studied. Ultrastructurally, some of the capillaries showed prominent multilaminar basement membranes surrounding their walls. The apical surface of the markedly swollen endothelial cells disclosed broad villous processes protruding into the lumen. Although this vascular lesion can be mistaken for angiosarcoma, it is considered benign. There was no evidence of recurrences of any of the six of the seven lesions that were completely excised and followed up (follow-up periods ranged from five to 95 months). Complete surgical excision appears to be the best treatment.

Adult↗

Cryotherapy and photocoagulation in the management of retinoblastoma: treatment failure and unusual complication.

Ophthalmologists treating children with retinoblastoma need to be aware of the limitations of new forms of therapy and their complications. For this reason the following case of a child with a small peripheral retinoblastoma that failed to respond to treatment with both cryotherapy and photocoagulation is recorded. The development of a rapidly growing juxtapapillary lesion prompted immediate enucleation. Histological examination revealed viable tumor cells remaining in the areas that were previously treated. The juxtapapillary mass consisted of optic nerve and detached peripapillary retina that were "dragged" towards the tumor by a thick fibrocellular membrane containing many myofibroblasts.

Cryosurgery↗

Sebaceous carcinomas of the ocular adnexa: A clinicopathologic study of 104 cases, with five-year follow-up data.

One hundred four cases of sebaceous carcinoma that arose from ocular adnexa, with at least five years' follow-up information following diagnosis, were studied to extend the authors' previous observations on various prognostic factors in these tumors. Twenty-three patients died from metastatic disease. Although sebaceous carcinomas elsewhere in the skin are rare, this study establishes that these neoplasms occur much more frequently in the ocular adnexa and have significant morphologic features that identify the more highly lethal carcinomas. The various clinicopathologic features that indicated a bad prognosis were vascular, lymphatic, and orbital invasion; involvement of both upper and lower eyelids; poor differentiation; multicentric origin; duration of symptoms greater than six months; tumor diameter exceeding 10 mm; a highly infiltrative pattern; and pagetoid invasion of the overlying epithelia of the eyelids. In many cases pagetoid change appeared to originate in the underlying sebaceous glands and from there extended to invade the overlying epithelia.

Adenocarcinoma↗

Fibrous histiocytoma of the orbit. A clinicopathologic study of 150 cases.

This is a clinicopathologic study of 150 cases of fibrous histiocytoma of the orbit. The tumors occurred in adults (median age, 43 years). The upper and nasal portions of the orbit were the most common sites of involvement. The most common signs and symptoms were proptosis (60 per cent), mass (46 per cent), and decreased vision (25 per cent). Based on the histopathologic features, the tumors were classified in three groups: benign (94 cases), locally aggressive (39 cases), and malignant (17 cases). The biological behavior correlated well with the duration of symptoms, the size and margins of the mass, and the histologic classification. The rate of recurrence was 31 per cent for the benign tumors, 57 per cent for the locally aggressive tumors, and 64 per cent for the malignant tumors. Follow-up data were obtained for 123 patients, with a mean duration of seven years. The ten-year survival of patients with benign, locally aggressive, and malignant fibrous histiocytoma was 100 per cent, 92 per cent, and 23 per cent, respectively. Nine patients died as a result of the tumor, six from local invasion of adjacent structures and three from metastatic disease. Fibrous histiocytoma is the most common primary mesenchymal orbital tumor of adults. The origin of the neoplasm is probably a primitive mesenchymal cell. Complete surgical excision appears to be the treatment of choice.

Adolescent↗

Conjunctival pigmentation associated with tetracycline medication.

A 26-year-old man had been treated for acne vulgaris with tetracycline and minocycline orally for 12 years. He developed dark brown to black pigmentary deposits in the palpebral conjunctiva bilaterally. These deposits resembled those seen in epinephrine pigmentation of the conjunctiva. Histologically the pigmented deposits were concretions in conjunctival cysts. Although they contained calcium, the concretions displayed the characteristic yellow autofluorescence of tetracycline under ultraviolet light. Presumably, tetracycline had formed extracellular chelation complexes with calcium, thus accounting for the pigmentation of the conjunctiva.

Adult↗

Juvenile fibromatosis of the periorbital region and eyelid. A clinicopathologic study of six cases.

Six cases of juvenile fibromatosis of the periorbital region and eyelid were studied. The median age of the patients was 8 years (range, 1 to 11 years). A definite propensity for involvement of the infraorbital region and lower eyelid was observed. THREE TUMORS EXHIBITED A PROMINENT LOBULAR PATTERN AND WERE ADHERENT TO THE PERIOSTEUM. The main entities in the differential diagnosis included leiomyoma, neurofibroma, and well-differentiated fibrosarcoma. Two of six tumors recurred locally but did not metastasize. Electron microscopic studies disclosed that the spindle-shaped tumor cells exhibited features of fibroblasts. It appears that conservative treatment (ie, local excision) is adequate.

Child↗

Trichilemmoma of eyelid and eyebrow. A clinicopathologic study of 31 cases.

Thirty-one cases of trichilemmoma of the eyelid and eyebrow were studied. All lesions were solitary, small, and asymptomatic. Unlike basal cell carcinoma of the eyelid, trichilemmoma rarely involves the lid margin or the inner canthus. The age range of our patients was from 22 to 88 years old (mean, 56 years). There were 19 men and 12 women. The most frequent clinical diagnoses were verruca vulgaris and cutaneous horn. Typically, the tumor displayed a lobular pattern and was composed mostly of glycogen-rich clear cells. The periphery of the lobules showed palisading of columnar cells and a distinct basement membrane. Histologically, the tumor was frequently misinterpreted as basal cell carcinoma. Review of the literature, including our own series, discloses that the eyelid is the second most common site for trichilemmoma after the nose.

Adult↗

The clinical spectrum of schwannomas presenting with visual dysfunction: a clinicopathologic study of three cases.

Schwannomas (neurilemomas) are benign tumors that arise from Schwann cells in the peripheral nervous system. The most commonly involved nerves that cause neuro-ophthalmic manifestations are cranial nerves V and VIII. In this series of three women, schwannomas presented as intraconal masses that mimicked a cavernous hemangioma, a superior orbital mass transgressing the superior orbital fissure, and an expansive frontal lobe mass with clinical symptoms and signs of increased intracranial pressure. Although all three complained of visual blurring, none of our patients presented with Vth or VIIIth cranial nerve dysfunction. Histopathologic studies demonstrated well-circumscribed, encapsulated spindle-cell lesions with classic Antoni A and B patterns. Histopathologic examination is essential to confirm the diagnosis of a schwannoma that may be otherwise clinically confusing. Direct optic nerve compression, globe indentation with induced hyperopia, or increased intracranial pressure with optic nerve compromise may be responsible for visual symptoms. A multidisciplinary approach is often required because of the size and location of schwannomas.

Adult↗

Borderline melanocytic tumor of the conjunctiva: diagnostic and therapeutic considerations.

A clinically benign appearing nevus was surgically excised from the conjunctiva of a 13-year-old girl because of complaints that it had recently enlarged. Histologically, the melanocytic lesion displayed considerable cytologic atypia and showed signs that were consistent with malignant transformation. Because of the rarity of conjunctival melanomas in children, the case was reviewed by several experienced pathologists and dermatopathologists whose diagnoses ranged from benign nevus with atypia to malignant melanoma. When the biologic potential of certain melanocytic lesions cannot be accurately predicted histologically, treatment and follow up must be individualized. Physicians must weigh the perceived risks and disadvantages of treating a histologically indeterminate tumor against the consequences of "under" treatment if the lesion is, in fact, biologically malignant.

Adolescent↗

Lipid deposits posterior to impermeable intracorneal lenses in rhesus monkeys: clinical, histochemical, and ultrastructural studies.

Synthetic materials are being evaluated for their potential long-term use in corneal refractive surgery. Clinical and histopathologic studies were performed with polymethylmethacrylate (PMMA) and polysulfone intracorneal lenses in rhesus monkey eyes that were followed for up to 3 years. The 5 mm diameter lenses were placed in the deep posterior corneal stroma of four eyes. Fine, polychromatic crystalline deposits formed a layer posterior to the implants. Enucleated eyes had the corneas either frozen for histochemistry or fixed for electron microscopy. Special stains included oil red 0 and filipin on fresh frozen tissue. The cornea, with a PMMA intracorneal lens showed myriad crystalline aggregates in the deep corneal stroma behind the implant. These crystalline deposits stained positively with oil red 0 and with filipin indicating the presence of neutral fat as well as unesterified cholesterol. The polysulfone implant showed no evidence of crystalline deposits histologically but was surrounded by homogeneous aggregates that could represent nonspecific reaction to the lens material or protein deposits. Electron microscopy of all four corneas revealed dissolved lipid aggregates and laminated electron dense material that were most abundant posterior to the implant where the keratocytes appeared disintegrated. The PMMA lens appeared to induce lipid keratopathy.

Animals↗