Erhan YUMUŞAK, Nesrin BÜYÜKTORTOP, Zafer ONARAN, Kemal ÖRNEK, Mahi BALCI

Kırıkkale Yöresinde Konjonktiva Lezyonlarının Histopatolojik Dağılımı

Amaç: Üçüncü basamak bir sağlık merkezi olan Kırıkkale Üniversitesi Tıp Fakültesi Hastanesi'nde konjonktival kitle şikayetiyle müracaat eden hastalardan alınan insizyonel yada eksizyonel biyopsi materyallerinin histopatolojik olarak incelenmesi ve klinik özellikleriyle beraber değerlendirilmesi. Gereç veYöntem: 2008-2016 yılları arasında konjonktiva lezyonu nedeniyle cerrahi uygulanan 80 hasta retrospektif olarak değerlendirildi. Klinik verilerhasta dosyalarından toplanarak elde edildi. Hastaların yaş ve cinsiyetleri ilelezyonun klinik ve histopatolojik özellikleri belirlendi. Bulgular: Çalışmadaki hastalardan 52'si (%65) erkek, 28'i (%35) kadın idi. Hastaların ortalama yaşı 42±21,6 yıl idi. Seksen konjonktival lezyondan 21'i pterjiyum-pingeikula (%26), 17'si kronik inflamasyon (%21.25), 13'u nevüs(%16.25), 6'sı aktinikkeratoz (%7.5) ,4'ü papillom (%5.0), 4'ü hemanjiom (%5.0), 3'ü lipom(%3.75), 1'i elastofibrom (%1.25), 1'i verrucavurgaris (%1.25), 1'i epidermal kist (%1.25), 9'u malign olgulardan (%11.25) oluştu. Malign olgular ise 5 intraepitelyal neoplazi (Tüm lezyonların %6.25'i), 3 skuamoz hücreli karsinom( tüm olguların %3.75'i), 1 malignmelanom (tüm olguların %1.25'i) olarak sıralandı. Sonuç: Çalışmamızda konjonktivanın en sık gözlenen lezyonu olarak pterjium benzeri lezyonlar bulunmuştur. Yaklaşık 8 olgudan birinde ise malign lezyon rapor edilmiştir.

Histopathologic Distribution of Conjunctival lesions around Kırıkkale Province

Aim:To evaluate the histopathological and clinical features of conjunctival lesions treated in a tertiary center, Kırıkkale University School of Medicine. Methods: Eighty patients who received conjunctival resection between 2008-2016 were evaluated retospectively. Clinical data were obtained from the medical records. Demographic data and clinical outcomes of the patients were reviewed. Results: In the study, there were 52 (65%) male and 28 (35%) female patients. Mean age of the patients was 42±21,6 years. 0f the 80 cases, 21 were (26%) pterygium -pinguecula , 17 (21.25%) chronic inflammation, 13 (16.25%) nevus, 6 (7.5%) actinic keratosis, 4 (5.0%) papilloma, 4 (5.0%) hemangioma, 3 (3.75%) lipom, 1 (1.25%) elastofibrom, 1 (1.25%) verruca vurgaris, 1(1.25%) epidermal kist, and 9 (11.25%) malign lesions. Malign cases were intraepitthelial neoplasm in 5 eyes ( 6.25%), squamous cel carcinoma in 3 eyes (3.75%) and malign melanoma in 1 eye (1.25%). Conclusion: Ptergium constituted the most common lesion of the conjunctiva. Malign melanoma was the least one eighth of all.

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1. Chandler JW, Sugar J, Edelhauser HF: External disease; in Podos SM, Myron Yanoff (eds): Textbook of Ophthalmology. St. Louis, Mosby,1994, pp1.1-2.7.
2. Chi MJ, Baek SH. Clinical analysis of benign eyelid and conjunctival tumors. Ophthalmologica 2006; 220: 43-51.
3. Amoli FA, Heidari AB. Survey of 447 patients with conjunctival neoplastic lesions in Farabi Eye Hospital, Tehran, Iran. Ophthalmic Epidemiol 2006; 13: 275-279. 5
4. Shields CL, Demirci H, Karatza E, Shields JA. Clinical survey of 1643 melanocytic and nonmelanocytic conjunctival tumors. Ophthalmology 2004; 111:1747-1754.
5. Shields CL, Fasiuddin AF, Mashayekhi A, Shields JA. Conjunctival nevi: clinical features and natural course in 410 consecutive patients. Arch Ophthalmol 2004; 122: 167-175.
6. Shields CL, Shields JA. Tumors of the conjunctiva and cornea. Surv Ophthalmol 2004; 49: 3-24.
7. Welch RB, Duke JR: Lesions of the lids. Am J Ophthalmol 1958; 45: 415-416. 4
8. Elshazly LHM.A Clinicopathologic Study of Excised Conjunctival Lesions. Middle East Afr J Ophthalmol. 2011; 18 (1): 48-54.
9. Amoli FA, Heidari AB. Survey of 447 patients with conjunctival neoplastic lesions in Farabi EyeHospital, Tehran, Iran. Ophthalmic Epidemiol 2006; 13: 275-279.)
10. Ceylan OM, Uysal Y, Erdurman FC, Gültekin K, Durukan AH, KöksalS, Mutlu FM, et al. Clinical and histopathological analysis of conjunctival tumors. Gulhane Med J 2010; 52 (4): 248-251
11. Zimmermann M A P, de la Riva J C G. Conjunctival tumors in children: histopathologic diagnosis in 165 cases.Arq Bras Oftalmol. 2015;78(6):337-9
12. Navahi R A, Ashraf M J, Seirfar N, Koohestani S, Abedi E. Conjunctival Lesions; a Histopathologic Review in Fars Province, Iran J Ophthalmic Vis Res. 2015;10(2):98-101.
13. Ateenyi-Agaba C, Weiderpass E, Smet A, et al. Epidermodysplasia verruciform is human papilloma virus types and carcinoma of the conjunctiva: A pilot study. Br J Cancer 2004;90: 1777-1779.
14. Kaimbo Wa Kaimbo D, Parys-Van Ginderdeuren R, Missotten L. Conjunctival squamous cell carcinoma and intraepithelial neoplasia in AIDS patients in Congo Kinshasa. Bull Soc Belge Ophtalmol 1998; 268: 135-141.
15. Yoon YD, Grossniklaus H. Tumors of the cornea and conjunctiva. Curr Opin Ophthalmol 1997;8: 55-58.
16. Oellers P, Karp CL, Sheth A, Kao AA, Abdelaziz A, Matthews JL, et al. Prevalence, treatment, and outcomes of coexistent ocular surface squamous neoplasia and pterygium. Ophthalmology 2013;120:445-450.
17. Hirst LW, Axelsen RA, Schwab I. Pterygium and associated ocular surface squamous neoplasia. Arch Ophthalmol 2009;127:31-32.