Treatment and histopathology of a congenital vitreous cyst

OBJECTIVE: This study aimed to evaluate the treatment efficacy of a congenital vitreous cyst and to examine the cyst histopathologically to determine its cellular makeup and possible origin. STUDY DESIGN: The study design was a case report, including a clinicopathologic correlation. INTERVENTION: A 35-year-old woman with a known vitreous cyst since childhood became increasingly troubled by its symptoms. The cyst was treated initially with argon laser photocoagulation. Vitrectomy subsequently was performed because the deflated cyst remained near the visual axis. Histopathologic studies included light and electron microscopy; immunocytochemistry for actin and glial fibrillary acidic protein (GFAP); and enzyme histochemistry for carbonic anhydrase (CA). RESULTS: The cyst was composed of a single layer of heavily pigmented cells with a thick basement membrane along the internal borders of the cells. Ultrastructurally, the cells were connected with tight junctions, had microvillous processes at their apices, and contained numerous large melanosomes in various stages of maturity, including premelanosomes. Immunochemistry showed the cells were positive for actin but negative for GFAP. Enzyme histochemical staining for CA also was strongly positive. CONCLUSIONS: The confinement of this cyst to the region of Cloquet's canal, the presence of a Mittendorf's dot, the cyst's existence for many years, and the finding of pigment epithelial-type cells having immature melanosomes (a feature not seen after birth in normal pigment epithelium) lead the authors to believe that this cyst was a congenital remnant of the primary hyaloidal system. Because pigmented cells are not normally present in this part of the eye, the cyst was a choristoma of the primary hyaloidal system.     

Calcified solitary renal cyst in childhood

There is a 20% incidence of malignancy in renal masses with rim calcification in adults. A case of rim calcification in a solitary renal cyst in a child is presented and the diagnostic approach and surgical management are described. Solitary renal cysts are extremely rare in children, with no reported cases of rim calcification.     

Squamous cell carcinoma and infection in a solitary hepatic cyst

A case of mediastinal cavernous hemangioma was reported. An abnormal shadow on the chest X-ray film was pointed out in a 55-year-old male. CT scan and MRI revealed a right posterior mediastinal tumor but did not aid in the final diagnosis. We underwent extirpation of the tumor through thoracoscope and confirmed to be a cavernous hemangioma histologically. No major vascular connections between the tumor and major vessels were found. It was useful of thoracoscopic surgery in this case.     

Isolation of a bioactive Ca(2+)-mobilizing complex lipid from bovine vitreous body

We have been undertaking the gene therapy for a 6 year-old boy with ADA deficiency and performed 11 cycles of the infusion of the peripheral T cells transduced with retroviral vector LASN since August 8th 1995. The percentage of the peripheral blood lymphocytes carrying the transduced ADA gene has remained stable at 10% to 20% since the 4th infusion. ADA enzyme activity in his circulating T cells increased to levels comparable to 1/3 of a heterozygous carrier individual and was associated with increased T lymphocytes counts and improvement in both humoral and cellular immune function. The results obtained in this clinical study support the usefulness of T lymphocyte-directed gene transfer in the treatment of ADA deficiency.     

A surgically treated unicameral (solitary) bone cyst of the talus with a 15-year follow-up

Unicameral bone cysts are uncommon in the foot. When they do occur, they must be differentiated from a variety of other benign lesions. The author describes a unicameral bone cyst of the talus, and its surgical management. The patient returned 15 years later with complaint of mild ankle joint arthrosis, although recurrence of the cyst was not demonstrated.     

Demonstration of immunoglobulin isotypes in the vitreous body as a contribution to the etiology of recurrent equine uveitis

The functional properties of different immunoglobulin isotypes in equine recurrent uveitis (ERU) has not been investigated yet. Here, we describe the quantitative determination of total immunoglobulin levels and isotype differentiation in the vitreous of four horses with ERU as compared to that of seven healthy horses. In contrast to almost equal amounts of total immunoglobulin in the vitreous of both groups, remarkable differences were found: All four of the horses with ERU had significantly higher IgA contents in their vitreous as compared to the control group. However, the other isotypes monitored (IgM, IgGa, IgGb, IgGc and IgG(T)) indicated no differences between both groups. Comparing the individual ratios of immunoglobulin isotypes in the vitreous and the autologous serum of two horses with ERU and two control animals provided informative results: IgM was only detected in serum but not at all in vitreous of all horses investigated. All four IgG isotypes monitored in the diseased animals as well as these IgG isotypes and the IgA in healthy animals were present in the same ratios in serum and in vitreous of the individual horses. In general, the content of such isotypes in the vitreous was about 1000 fold lower then the respective isotypes in the autologous serum. These results are compatible with a transfer of the IgG and IgA isotypes from the serum into the vitreous in healthy individuals. All four horses with ERU, however, had a selectively increased relative IgA content in the vitreous as compared to their serum. This argues for a preferential local IgA production within the framework of a local immunological reaction to antigens located within the eyes of horses with ERU.     

Case report: calcification within aneurysmal bone cyst

Aneurysmal bone cyst (ABC) usually affects older children or young adults. The radiological appearance is of a purely osteolytic expansile metaphyseal lesion with thinned out cortex and internal septations. We present a case of ABC in a 5-year-old girl which showed internal calcification and was initially diagnosed as enchondroma. However, pathological examination revealed typical appearance of ABC with large area of dystrophic calcification.     

Epidermoid cyst of the brain stem. Case report

OBJECTIVE: To search for the effect and safety of coral porous hydroxyapatite (CHA) implanted material in orbital rim reconstruction. METHODS: 7 cases of orbital rim reconstruction were treated with CHA which is a plate form mass with an interconnected system of canals of approximately 200 microns in size. It has three types: 1.0 cm x 1.5 cm x 5.0 cm, 0.6 cm x 1.5 cm x 5.0 cm and 0.4 cm x 1.5 cm x 5.0 cm. According to the shape of a contralateral healthy orbit, a rubber putty model was made before the operation. An incision was designed at the upper 1/3 of the face for the elimination of wrinkles or a prolonged incision of lower lid bag plastic surgery was made. After the exposure of the defective part of the orbit, a correctly molded CHA tamponade was inserted. RESULTS: The orbital rim reconstruction in 7 cases with orbital defect was successfully treated with CHA. During a follow-up of 3-12 months (average 6.6 months), there was no extrusion or migration of implant. CONCLUSION CHA is a good material for substitution of bone graft and is much better than autogenous tissue of other artificial materials.     

Comparative study of incomplete posterior vitreous detachment as a risk factor for proliferative vitreoretinopathy

BACKGROUND: Abnormal vitreoretinal relationships have recently been implicated in many vitreoretinal disorders. Sites of abnormal vitreoretinal adherences are likely to exist in eyes predisposed to rhegmatogenous retinal detachment (RD), causing either retinal tears or incomplete posterior vitreous detachment (PVD). The present study was designed in two parts to identify the risk for preoperative and postoperative proliferative vitreoretinopathy (PVR) due to incomplete PVD. METHODS: We prospectively evaluated the vitreoretinal relationships using high-resolution kinetic echography in 102 consecutive eyes of 100 patients with rhegmatogenous RD. In the first part, a case-control study was conducted to compare the vitreous status in patients with preoperative PVR (cases) with that in patients with non-PVR-complicated RD (controls). During the second part, patients with noncomplicated RD (65 eyes) who were operated on by a simple retinal attachment procedure were followed up for a mean period of 6.6 months to compare the recurrence of RD due to postoperative PVR according to their vitreous status. RESULTS: Patients with PVR on study entry had a higher prevalence of partial PVD (28 of 32 eyes, 87%) than did controls (25 of 70 eyes, 35%). The statistical significance of this difference was independent of all other variables studied. After a mean follow-up period of 6.6 months, the incidence of recurrence of RD associated with postoperative PVR was 33% in the eyes with incomplete PVD, compared with 4.9% in the eyes without incomplete PVD. CONCLUSIONS: Our results support the notion that the occurrence of incomplete PVD in RD is a significant risk factor for preoperative and postoperative PVR.