Actinic keratosis and dysplasia of the conjunctiva: a clinicopathological study of 45 cases.
OBJECTIVE
To characterize precancerous conjunctival intraepithelial tumours on file at the Armed Forces Institute of Pathology (AFIP).


METHODS
Chart review.


METHODS
Registry of Ophthalmic Pathology of the AFIP.


METHODS
Forty-five patients with intraepithelial neoplastic lesions of the conjunctiva followed for at least 2 years.


METHODS
Extent; papillomatous pattern; degree of parakeratosis, hyperkeratosis and atypia; and amount of solar elastosis.


RESULTS
Based on their histologic appearance, 24 cases were classified as actinic keratosis and 21 cases as dysplasia. Clinically, lesions classified as actinic keratosis tended to be focal and leukoplakic, whereas those classified as dysplasia tended to be diffuse and gelatinous. Two of the lesions classified as actinic keratosis recurred, compared with 13 of the lesions classified as dysplasia. In one patient with dysplasia locally invasive squamous cell carcinoma developed after numerous recurrences, requiring orbital exenteration. The degree of atypia was not correlated with recurrence in either group.


CONCLUSIONS
Most intraepithelial neoplastic lesions of the conjunctiva can be readily diagnosed by the ophthalmic pathologist as either actinic keratosis or dysplasia.
Mauriello
J A
JA
Department of Ophthalmology, New Jersey Medical School, Newark 07103, USA.
Napolitano
J
J
McLean
I
I
D002278:Carcinoma in Situ / Q000209:etiology / Q000473:pathology*; D003229:Conjunctival Diseases / Q000209:etiology / Q000473:pathology*; D003230:Conjunctival Neoplasms / Q000209:etiology / Q000473:pathology*; D004848:Epithelium / Q000473:pathology; D005260:Female; D006801:Humans; D007642:Keratosis / Q000209:etiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000209:etiology / Q000473:pathology*; D012189:Retrospective Studies; D014466:Ultraviolet Rays / Q000009:adverse effects*