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Biomedical subjects

L Mottow-Lippa

Publications and source records attributed to L Mottow-Lippa.

5 recordsLinked to original sources

Conjunctival myxoma. A clinicopathologic study.

A 54-year-old white man had a slowly growing painless epibulbar mass that clinically mimicked a lymphangioma. Morphologically, the paucicellular tumor contained stellate and spindly cells, mast cells, and dilated lymphatic channels embedded in a loose collagenous matrix. The clinical differential diagnosis included lymphangioma, amelanotic nevus, lymphoma, reactive lymphoid hyperplasia, dermoid, lipoma, and botryoid rhabdomyosarcoma. Pathologically, lymphangioma, myxoid neurofibroma, and spindle cell lipoma were all considered. The authors discuss the clinical and histopathologic features of the various tumors, and confirmation of the diagnosis of conjunctival myxoma by differential alcian blue staining properties dependent on critical electrolyte concentration.

Conjunctiva↗

Treatment of large von Hippel tumors by eye wall resection.

Two large angiomas (greater than 3 disc diameters) in two patients with von Hippel disease were removed successfully by eye wall resection. The resection of angioma in the first case resulted in improved visual acuity from counting fingers to 20/140, decreased exudates, and cessation of preoperative diffuse retinal capillary leakage observed by fluorescein angiography. The resection in the second case with pre-existing local tractional retinal detachment was tolerated well. The patient retained her preoperative visual acuity of 20/25, and retinal traction was released. Although a complicated surgical procedure, resection of large angiomas offers a good alternative therapy to tumors resistant to cryocoagulation or photocoagulation.

Adult↗

von Hippel angiomatosis. A light, electron microscopic, and immunoperoxidase characterization.

A 25-year-old Iranian man had undergone eye wall resection of a large von Hippel angioma to alleviate an exaggerated macular response, affording study by light and electron microscopy and immunohistochemistry before the obfuscatory effects of long-standing exudative retinal detachment, gliosis, or iatrogenic ablation supervened. We used this vantage point to assess the interrelation between the component endothelial cells, pericytes, and stromal foam cells. On the basis of staining with glial fibrillary acidic protein, factor VIII, the C3 fraction of complement, fibrinogen, and lysozyme, it is unlikely that stromal foam cells derive from glial precursors, but may represent degenerating cells, perhaps arising from a common vasoformative stem cell under hypoxic stress.

Adult↗

Idiopathic inflammatory orbital pseudotumor in childhood. II. Results of diagnostic tests and biopsies.

Twenty-nine patients with pediatric orbital pseudotumor underwent a wide variety of diagnostic tests including biopsies. The following abnormalities were discovered: peripheral blood eosinophilia (9/29 patients); elevated ESR (17/27); elevated antinuclear antibody titres in the Tolosa-Hunt variant (2/2); hypercomplementemia (2/3); and mild CSF pleocytosis (2/6). Thyroid function tests were normal in nine patients so studied. B-mode ultrasonography performed on 12 patients displayed abnormalities in all cases (some combination of Tenonitis, myositis, perioptic inflammation, or mass effect). Computed tomography in seven patients provided higher resolution confirmation of these findings. Orbital bone changes and serious sinus disease were absent on routine radiographic studies. Biopsies performed on 16 patients disclosed mild lymphocytic inflammation in all cases, fibrosis and tissue eosinophilia in 9 biopsies (6 correlating with peripheral blood eosinophilia). Nine biopsies demonstrated a lipogranulomatous response to damaged fat cells. A true vasculitis or extensive lymphoid hyperplasia was not identified in any biopsy specimen.

Child↗

Pseudoinflammatory metastatic breast carcinoma of the orbit and lids.

A 60-year-old woman presented five years after a radical mastectomy for breast carcinoma, with vague, non-specific complaints referable to the left eye, consisting of ptosis, extraocular motility problems, and irritation, all believed initially to be due to an inflammatory causation. The indurated quality of the involved tissues, coupled with the results of computed tomographic studies, led to the suspicion of the correct diagnosis, namely, metastatic scirrhous carcinoma of the ocular adnexa. Biopsy and electron microscopic studies confirmed this diagnosis. Clinical and pathologic pitfalls in failing to distinguish scirrhous carcinoma from an inflammatory lesion are discussed.

Adenocarcinoma, Scirrhous↗