Abstract
The ocular surface is exposed to many chronic inflammatory stimuli, and goblet cell hyperplasia of the conjunctiva occurs in many situations. We report two cases of epithelial goblet cell hyperplasia with nonspecific chronic inflammation which occurred on the internal canthus of elderly people. These cases shared the same clinicopathological features that mimicked neoplastic lesion macroscopically, but are composed of nonspecific inflammatory changes pathologically. Immunostaining of the tissue showed few IgG4+ plasma cells, and no neoplastic changes were observed. Both cases arose in elderly patients over the age of 80 years. Pathogenesis and clinical significance of the lesion is unclear, but it might be age related. Recognition of this diagnosis might help us avoid overdiagnosis of malignancy and to reach the correct diagnosis.
This is a preview of subscription content, log in via an institution to check access.
References
Ito T (1991) Soshikigaku (Histopathology), 6th edn. Nanzando Co., Ltd. pp 319–321
Okisaka S (1992) Ganbyouri atlas (An atlas and textbook of ocular histopathology), Bunkodo Co., Ltd. pp 9–11
Novaes P, Hilario P, do Nascimento Saldiva, Kara-Jose N, Macchione M, Matsuda M, Racca L, Berra A (2007) Ambient levels of air pollution induce Goblet-cell hyperplasia in human conjunctival epithelium. Environ Health Perspect 115:1753–1756
Margo CE, Grossniklaus HE (2001) Pseudo adenomatous hyperplasia of the conjunctiva. Ophthalmology 108:135–138
Roat MI, Ohji M, Hunt LE, Thoft RA (1993) Conjuctical epithelial cell hypermitosis and goblet cell hyperplasia in atopic keratokonjunctivitis. Am J Opthalmol 116:456–463
Muruve J, Rivas L (2003) Biopsy of the conjunctiva in dry eye patients establishes a correlation between squamous metaplasia and dry eye clinical severity. Eur J Opthalmol 13:246–256
de Paiva CS, Villarreal AL, Correles RM, Rahman HT, Chang VY, Farley WJ, Stern ME, Niederkorn JY, Li DQ, Pflugfelder SC (2007) Dry eye-induced conjunctival epithelial squamous metaplasia is modulated by interferon –γ. Invest Opthalmol Vis Sci 48:2553–2560
Geneva Ivayla I, Eagle Ralph C, Jr Ann Barker-Griffith, Stefanyszyn Mary, Weisenthal Robert (2013) Squamous metaplasia of the conjunctiva: a previously unrecognized adverse effect of risedronate sodium. JAMA Opthalmol 131:249–251
Rosai J (2011) Rosai and Ackerman’s surgical pathology, 10th edn. Mosby Elsevier, St. Louis, p 2483
Fletcher Christopher DM (2013) Diagnostic histopathology of tumors, vol 4. Elsevier Saunders, Philadelphia, pp 2093–2095
Whaley K, Williamson J, Wilson T, McGavin DDM, Hughes GRV, Hughes H, SHmulian LR, Macsween RNM, Buchanan WW (1972) Sjogren’s syndrome and autoimmunity in a geriatric population. Age Ageing 1:197–205
Abdel-Khalek LMR, Williamson J, Lee WR (1978) Morphological changes in the human conjunctival epithelium. I. In the normal elderly population. Br J Opthalmol 62:792–799
Zhu W, Hong J, Zheng T, Le Q, Xu JJ, Sun X (2010) Age-related changes of human conjunctiva on in vivo confocal microscopy. Br J Opthalmol 94:1448–1453
Doughty Michael J (2012) Goblet cells of the normal human bulbar conjunctiva and their assessment by impression cytology sampling. Ocul Surf 10:149–169
Levy J, Deckel Y, Maly A, Pe’er J (2009) Lesions of the caruncle: a description of 42 cases and a review of the literature. Eye 23:1004–1101
Conflicting of interests
The authors declared no potential conflicts of interest with respect to research, authorship, and/or publication of this article.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ohashi, A., Elsayed, A.A., Yasuma, T. et al. Conjunctival mucoepithelial hyperplasia of the elderly. Int Ophthalmol 35, 611–614 (2015). https://doi.org/10.1007/s10792-015-0083-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10792-015-0083-5