Homolaterale episklerale Metastase oder chirurgische Aussaat eines Proton-bestrahlten Ziliarkorpermelanoms? [Homolateral episcleral metastasis or surgical seeding of a proton-irradiated ciliary body melanoma?]

In an eye with a proton beam-irradiated malignant melanoma of the ciliary body a second melanoma appeared episclerally on the opposite side of the globe. Microscopic examination did not show any connection to the primary tumor. The different possibilities of pathogenesis (bloodborn metastasis to the same globe, episcleral metastasis by conjunctival lymphatics, surgical dissemination due to the suturing of tantalum marks around the primary tumor) are discussed. The ciliary melanoma has spread over the iris despite the irradiation, probably as a result of insufficient irradiation of its anterior border. The results of histologic examination of the partially necrotic, partially viable irradiated tumor are considered with regard to the conservative tumor therapy administered

Primary gelatinous drop-like corneal dystrophy in a white woman. A pathologic, ultrastructural, and immunohistochemical study

A white female with primary gelatinous drop-like corneal dystrophy (PGDD) was followed from the ages of 8 to 37 years. During this time, she underwent repeated lamellar and penetrating keratoplasties on both sides due to relapsing bilateral corneal opacifications. The diagnosis of PGDD was based on the histology of the corneal specimens obtained at 10 and 36 years of age, as well as on the characteristic clinical appearance and course. Electron microscopy showed typical amyloid fibrils. Immunohistochemical staining was mildly positive for amyloid AL (light chain), but negative for amyloid AA, AF, AB, and keratin. Thus, the precursor protein of the amyloid deposits in PGDD might derive from immunoglobulins, e.g., from the tear film. However, the precursor protein might derive from a different origin altogether. In that case, the positive staining for amyloid AL would translate nonspecific absorption of fragments of light chains

Non-vascular smooth muscle cells in the human choroid: distribution, development and further characterization

To characterize further non-vascular smooth muscle cells (NVSMC) in the choroid of the human eye, extensive morphological studies were performed including a three-dimensional distribution of NVSMC in the adult human eye and their appearance during development. Whole mounts and sections through the choroid and sclera of eyes of 42 human donors (between the 13th week of gestation and 89 years of age) were stained with antibodies against smooth muscle actin and other markers for smooth muscle cells. On the basis of their morphological localization, three groups of NVSMC could be distinguished in the adult eyes: (a) a semicircular arrangement of NVSMC in the suprachoroid and inner sclera, around the entry of posterior ciliary arteries and nerves; (b) NVSMC parallel to the vessels in the posterior eye segment between the point of entry of the posterior ciliary arteries and the point of exit of the vortex veins; and (c) a dense plaque-like arrangement of NVSMC in the suprachoroid, overlying the foveal region. The last of these groups showed most pronounced interindividual differences. During development, the first NVSMC to be observed at the 20th week of gestation belonged to group b. A complete NVSMC network was first observed in a 6-year-old donor eye. All three groups stained positive for smoothelin, caldesmon and calponin in all localizations. The NVSMC show a distinct distribution that might reflect different aspects of their function in the choroid and suprachoroid. All cells could be histochemically characterized as truly contractile