|Year : 1976 | Volume
| Issue : 1 | Page : 32-33
Angiomatous implantation cyst of the conjunctiva
Thakur R.D Sinha1, AP Verma2
1 Department of Eye, Medical College & Hospital, Bhagalpur, India
2 Department of Pathology and Microbiology, Medical College & Hospital, Bhagalpur, India
Thakur R.D Sinha
Department of Eye, Medical College & Hospital, Bhagalpur
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Sinha TR, Verma A P. Angiomatous implantation cyst of the conjunctiva. Indian J Ophthalmol 1976;24:32-3
A case is presented of a child with an implantation cyst of the conjunctiva showing an unusual angiomatous character of the cyst wall and complete absence of any history of trauma.
| Case Report|| |
A boy aged 10 years attended the department of ophthalmology, Bhagalpur Medical College and Hospital with complaint of watering from the left eye and its frequent redness, since two years.
On examination one small fluctuating, non-pedunculated globular swelling of an approximate size of 5 x 3 mm was noted in the lower fornix ([Figure - 1]. Lower left). The surface of the cystic swelling was smooth. The swelling was noted to be blended with the conjunctiva and the conjunctiva over and around the cyst was found to be congested. Examination of cornea and the fundus did not reveal any abnormality. The movements of the eye ball were normal. There was no previous history of trauma operative or otherwise.
Haematological investigations were non-contributory.
A total cystectomy was done under general anaesthesia. Contents of the cyst were found to be serosanguinous. It was a unilocular cyst.
Histology of the cyst wall
The histological appearance of the cyst wall was typical of an implantation cyst at places, the down growths of the epithelial lining were seen. [Figure - 1] (upper left) shows one such down growth in the subepithelial tissue but still attached to the lining cells of the cyst wall. The higher magnification of the same down growth ([Figure - 1], right) shows a solid clump of epithelial cells containing a few mucous cells and some necrotic debris obviously tending to form a cyst. A very small such cystic space is visible ([Figure - 1] right) in about its centre. [Figure - 2] left shows one microcyst which in the higher magnification ([Figure - 2] right) shows its lining cells in several layers closely resembling those of the main cyst wall. Another solid clump of epithelial cells detached from the lining cells of the main cyst wall is shown in [Figure - 3]. The clump of epithelial cells shows a few mucous cells but there is no cyst formation. These cells too resemble the lining epithelial cells of the main cyst wall.
The cyst wall is highly vascular [Figure - 4] and in most places the blood vessels are arranged in groups. This is an important and rare finding.
| Discussion|| |
Conjunctiva) cysts are not very common. Among the common conjunctiva) cysts implantation cysts are not as common as lymph cysts and retention cysts. In the present case the light pink colour of the cystic swelling, the serosanguinous content of the cyst and such a gross vascularity of the cyst wall will eventually lead one to think of haemangiomas of the conjunctiva.
The haemangioma as a whole and particularly those of conjunctiva are extremely rare. According to the well reasoned contention of Willis (1967) most of the so called angiomas are not true tumours but vascular malformations of Hamartomas while some others are masses of reparative tissue and also the distinction between a true neoplasm and the hamartomas of vascular tissue is not always easy. In his opinion many of the vascular tumours of other kinds have been wrongly diagnosed as 'angiomas'. The present case also leads the author to believe that true haemangiomas of conjunctiva are extremely rare and at least some of the cases so reported may be markedly angiomatous variety of the implantation cysts or the hamartomas. Another important point worth mentioning in the present case is the absence of any history of trauma. In the causation of the implantation cysts the role of trauma is very much stressed. The trauma may be operative or otherwise, but in the present case there is no history of trauma. It is difficult to rule out completely the possibility of trauma in the present case, but it is certainly worth noting that even if the trauma is a factor, it must be a trivial one so as to pass unnoticed. Hence absence of history of trauma does not rule out the diagnosis of implantation cyst.
| Summary|| |
A case of implantation cyst of the conjunctiva in a boy of 10 years with an unusual angiomatous change in the cyst wall and complete absence of the previous history of trauma is presented.
| References|| |
Duke-Elder, 1964. Parsoins disease of the Eye, London Fourteenth Ed. 184.
Keith Lyle, T & Cross AG. 1954. May and Wroth's Manual of disease of Eye Bailliere, Tindall and Cox, London Eleventh Ed. 168.
Willis, R.A. 1967. London, Butter Wroth. 4 Ed. 718.
[Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4]