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Ophthalmic pterygium: a stem cell disorder with premalignant features
Jeanie Chui1, Minas T Coroneo, Lien T Tat
1Inflammation and Infection Research Centre, School of Medical Sciences, University of New South Wales, Sydney, Australia.
The American Journal of Pathology
|February 2, 2011
Summary
Pterygia, often seen as degenerative, can harbor significant preneoplastic lesions. Histological examination of excised pterygia is crucial for detecting concurrent ocular surface diseases.
Area of Science:
- Ophthalmology
- Ocular Surface Disease
- Surgical Pathology
Background:
- Pterygia are common ocular surface lesions linked to UV exposure.
- Traditionally viewed as degenerative, pterygia exhibit tumor-like characteristics, including invasion and recurrence.
- They may coexist with premalignant ocular surface conditions.
Purpose of the Study:
- To determine the frequency of concurrent ocular surface diseases in patients with pterygia.
- To investigate the histopathological features of pterygium specimens.
- To explore the cellular origins of pterygia.
Main Methods:
- Retrospective histopathological review of 100 pterygium specimens.
- Immunohistochemical assessment of selected cases.
- Clinical correlation with surgical observations.
Main Results:
- Beyond typical pterygium features, significant concurrent lesions were found: 5 ocular surface squamous neoplasias, 6 primary acquired melanoses, 2 nevi (1 suspect melanoma), and 1 dermoid-like lesion.
- P63-α-positive epithelial cell clusters were identified in 18 specimens, correlating with Fuchs' flecks.
- These findings suggest pterygia can be associated with preneoplastic conditions.
Conclusions:
- Excised pterygia frequently harbor significant preneoplastic lesions and require thorough histological examination.
- The presence of p63-α-positive cells supports the hypothesis of pterygium development from limbal epithelial progenitors.
- This study highlights the importance of histopathology in managing pterygium patients.
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