14. WHO classification of tumours of
the lacrimal drainage system
■ Epithelial tumours
■ Squamous cell carcinoma NOS
■ Non – keratinizing squamous cell
carcinoma
■ Adenocarcinoma NOS
■ Mucoepidermoid carcinoma
■ Adenosquamous carcinoma
■ Adenoid cystic carcinoma
■ Lymphoepithelial carcinoma
■ Sinonasal papilloma , inverted
type
■ Sinonasal papilloma , exophytic
■ Other tumours
■ Melanoma NOS
■ Extranodal marginal zone
lymphoma of mucosa associated
lymphoid tissue
■ Secondary tumours
15. Steps for processing of specimen
■ Fixation to preserve the tissue
■ Gross dissection to prepare the specimen for histologic sectioning
■ Tissue processing
■ Slide preparation and tissue staining
16.
17.
18.
19.
20. Hemangioma
■ Capillary hemangioma , the most common periocular vascular
tumour in infancy and childhood
■ Solitary , bright red , smooth
■ A variant of capillary hemangioma , often called
hemangioendothelioma is observed at birth , infancy or early
childhood
■ Histologically , the capillary hemangioma is composed primarily
of capillaries lined by plump endothelial cells
24. ■ Cavernous hemangioma is the most common primary orbital
tumour producing exophthalmos
■ It is a well- encapsulated tumour , usually within the muscle
cone
26. Histologic section shows large, blood filled spaces
of tumor lined by endothelium and separated by
fibrous septa of different thicknesses
27. Diagnostic criteria for extranodal
lymphomas
■ Histologic criteria
■ Features strongly associated with lymphoma
■ Relatively monomorphic lymphoid infiltrate
■ Cytologic atypia
■ Infiltrative growth with effacement of architecture
■ Plasma cells
28. ■ Dutcher bodies
■ Features suggestive of lymphoma
■ Lymphoepithelial lesions
■ Reactive features often associated with low-grade extranodal
lymphomas
■ Reactive follicular centers , mantle zones often irregular or
absent
39. Retinoblastoma
■ One of the most common childhood malignancies
■ The most common childhood intraocular neoplasm
■ 20% of the world’s retinoblastoma patients live in india , which
has 1500 new cases annually , more cases than any other country
40. Characteristically, sections of retinoblastoma stained with
hematoxylin and eosin and viewed under low
magnification show dark blue areas surrounded by light
pink areas . The dark areas represent viable cells and
calcium deposition , whereas the light areas represent
tumour necrosis
41. Increased magnification shows viable (dark blue) tumor cells
clustered around central blood vessels and surrounded in turn by
a mantle of necrotic cells (pink).Numerous Flexner-wintersteiner
rosettes are present
42. Types of rosettes : A Flexner- wintersteiner rosette
consists of a central lumen lined by cuboidal tumour cells
that contain nuclei positioned basally (away from the
lumen )
43. Homer Wright rosettes are found more frequently in
medulloblastomas and neuroblastomas than in retinoblastomas.
In these rosettes , the cells line up around an acellular area that
contains cobweb- like material
44. Fleurettes are flower like groupings of tumor cells in the
retinoblastoma . The cells of fleurettes show clear
evidence of differentiation into photoreceptor elements
47. Histologic section shows a sudden and abrupt transition from the
normal conjunctival to a markedly thickened epithelium. The
lesion is broad based and shows numerous blood vessels
penetrating into the thickened epithelium
48. Squamous cell carcinoma : the patient had a vascularised
elevated pearly lesion at the temporal limbus in the right
eye
49. Histologic section shows full thickness atypia and loss of
polarity . A diagnosis of carcinoma in situ would be made
here
50. Malignant epithelial cells in the substantia propria of the
conjunctiva ,forming keratin pearls in some areas
representing invasive squamous cell carcinoma
57. Oil red-O fat stain shows marked positivity in the
cytoplasm of abnormal cells
58. Large tumour cells are scattered throughout the surface
epidermis , simulating paget’s disease(i.e.pagetoid change). The
cancerous invasion of the epithelium can cause a chronic
blepharoconjunctivitis (masquerade syndrome)
59. Immunohistochemistry –IHC
■ Positive stains
■ Androgen receptor
■ Keratin
■ EMA
■ LeUM1
■ KI67-increased relative to sebaceous adenoma and sebaceoma
■ P53-increased relative to sebaceous adenoma and sebaceoma
■ BerEP4
