title: High-frequency ultrasonographic evaluation of conjunctival intraepithelial neoplasia and squamous cell carcinoma.
abstract: OBJECTIVE
  To evaluate the high-frequency B-scan ultrasonographic characteristics of squamous conjunctival neoplasia (conjunctival intraepithelial neoplasia and squamous cell carcinoma).
  
  
  METHODS
  Each of 11 patients was examined with 20- and/or 50-MHz ultrasonography in a retrospective consecutive case series.
  
  
  METHODS
  Ultrasonographic findings with clinical and histopathologic correlations.
  
  
  RESULTS
  Eleven eyes of 11 patients (8 men) were affected. Disease involved the right eye in 6 (55%) of the patients and the left eye in 5 (45%) of the patients; it was multifocal in 5 (45%) of the eyes. All tumors extended to, or primarily involved, the limbal conjunctiva. One patient developed superficial spread overlying a functioning partial-thickness filtering bleb, 1 developed intraocular extension, 1 developed scleral invasion, and 3 developed orbital involvement before treatment. Results of ultrasonographic examinations showed that the superficial aspect of the smaller limbal tumors appeared as fusiform thickening of the conjunctiva. In all patients, the tumor surface was highly reflective in contrast to the characteristically low reflectivity seen within the tumor stroma. Intraocular tumor extension was variably reflective, but evidenced by blunting of the anterior chamber angle and thickening of the uvea. Orbital extension was viewed as low reflective tumor extension into the relatively hyperechoic orbital tissues.
  
  
  CONCLUSIONS
  High-frequency ultrasonography may be used to assess the extent of squamous conjunctival neoplasia. While the 50-MHz system offered better resolution, 20-MHz ultrasonography allowed for a wider and deeper field of view. High-frequency ultrasonography was useful in determining tumor thickness, shape, and internal reflectivity, and especially in revealing tumor extension into the sclera, eye, and orbit.
authors.affiliation: Eye Cancer Center, The New York Eye and Ear Infirmary, 115 E 61st St, New York, NY 10021, USA. pfinger@eyecancer.com
authors.forename: Paul T
authors.initials: PT
authors.lastname: Finger
authors.forename: Hoai Viet
authors.initials: HV
authors.lastname: Tran
authors.forename: Roger E
authors.initials: RE
authors.lastname: Turbin
authors.forename: Henry D
authors.initials: HD
authors.lastname: Perry
authors.forename: David H
authors.initials: DH
authors.lastname: Abramson
authors.forename: Kimberly
authors.initials: K
authors.lastname: Chin
authors.forename: Robert
authors.initials: R
authors.lastname: Della Rocca
authors.forename: Robert
authors.initials: R
authors.lastname: Ritch
mesh_terms: D002278:Carcinoma in Situ / Q000000981:diagnostic imaging* / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000473:pathology; D003230:Conjunctival Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D009361:Neoplasm Invasiveness; D012189:Retrospective Studies; D014463:Ultrasonography