Consultations in Eye Pathology: Experience at an Ophthalmology Specialty Hospital.

IF 3.7 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY
Tatyana Milman, Orlando G Gonzalez Martinez, Martin Calotti, Roger K Henry, Ralph C Eagle
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Abstract

Context.—: Ophthalmic pathology is a discipline that relies heavily on a knowledge of clinical ophthalmology. The diagnosis of ocular and periocular lesions can be challenging because some lesions and diseases are unique to this region, whereas others may demonstrate site-specific differences from nonocular counterparts. Because of these challenges, ocular and periocular biopsies are frequently referred to specialized ophthalmic pathology centers for second-opinion diagnoses.

Objective.—: To analyze the referral patterns, diagnostic challenges, and diagnostic discrepancies for second-opinion referrals at a dedicated ophthalmic pathology laboratory with an emphasis on lesions of special interest in ophthalmic pathology.

Data sources.—: Data sources included the pathology records of all slides and blocks received in consultation at the referral eye pathology center between December 1, 2015, and December 1, 2022, the personal experience of senior authors, and published peer-reviewed literature.

Conclusions.—: Corneal, intraocular, and conjunctival biopsies are the most common types of cases received in consultation without the referring pathologist's diagnosis, likely reflecting diagnostic challenges. Degenerative intraocular processes occasionally raise concern for a neoplasm. Conjunctival melanocytic lesions are the most common conjunctival biopsies referred for second-opinion diagnosis and require careful tissue sampling and clinical-pathologic correlation. Careful clinical-pathologic correlation, a high level of suspicion, and adequate sampling also are required for the accurate diagnosis of periocular sebaceous carcinoma. The diagnostic discrepancies involving uveal, retinal, conjunctival, eyelid, and temporal artery biopsies are most likely to adversely influence patient management and possible outcome. Such specimens may benefit from referral to specialized ophthalmic pathology laboratories.

眼科病理学咨询:眼科专科医院的经验。
背景:眼科病理学是一门在很大程度上依赖于临床眼科知识的学科。眼部和眼周病变的诊断可能具有挑战性,因为有些病变和疾病是眼部和眼周区域特有的,而有些病变和疾病则可能表现出与非眼部病变和疾病不同的部位特异性。由于这些挑战,眼部和眼周活检经常被转诊到专门的眼科病理中心进行第二意见诊断:分析眼科病理专门实验室二次病理诊断的转诊模式、诊断难题和诊断差异,重点关注眼科病理特别关注的病变:数据来源包括2015年12月1日至2022年12月1日期间转诊眼科病理中心收到的所有会诊切片和切块的病理记录、资深作者的个人经验以及已发表的同行评审文献:角膜、眼内和结膜活检是会诊中最常见的病例类型,而转诊病理学家却未给出诊断,这可能反映了诊断方面的挑战。眼内退行性病变偶尔会引起对肿瘤的关注。结膜黑素细胞病变是最常见的结膜活检病例,需要仔细的组织取样和临床病理对照才能进行二次诊断。要准确诊断眼周皮脂腺癌,还需要仔细的临床病理相关性、高度怀疑和充分取样。涉及葡萄膜、视网膜、结膜、眼睑和颞动脉活检的诊断差异最有可能对患者的治疗和可能的结果产生不利影响。将此类标本转介到专门的眼科病理实验室可能会有所帮助。
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来源期刊
CiteScore
9.20
自引率
2.20%
发文量
369
审稿时长
3-8 weeks
期刊介绍: Welcome to the website of the Archives of Pathology & Laboratory Medicine (APLM). This monthly, peer-reviewed journal of the College of American Pathologists offers global reach and highest measured readership among pathology journals. Published since 1926, ARCHIVES was voted in 2009 the only pathology journal among the top 100 most influential journals of the past 100 years by the BioMedical and Life Sciences Division of the Special Libraries Association. Online access to the full-text and PDF files of APLM articles is free.
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