Eye
Conjunctiva
Pterygium


Topic Completed: 1 May 2013

Revised: 7 May 2019

Copyright: 2004-2019, PathologyOutlines.com, Inc.

PubMed Search: Pterygium conjunctiva [title]

Deepali Jain, M.D.
Page views in 2018: 6,944
Page views in 2019 to date: 6,061
Cite this page: Jain D. Conjunctiva: pterygium. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/eyepterygium.html. Accessed July 24th, 2019.
Definition / general
Clinical features
  • Causes significant changes in corneal refractive status, these increase with grade of pterygia (Indian J Ophthalmol 2007;55:383)
  • High prevalence (18%) in those age 40+ years living at high altitude in Mongolia (Eye (Lond) 2009;23:421)
  • Clinically may resemble melanoma or dysplasia
  • Not related to multiple pterygium (webbing) syndrome (Am J Hum Genet 2006;79:390)
  • Recurs but does not undergo malignant transformation
Treatment
  • Excision for cosmetic reasons, visual impairment, recurrent inflammation, mild irritation
Clinical images

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Pterygium

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Cutaneous elements in recurrent pterygium

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Wing-like conjunctival overgrowth of cornea

Gross description
  • Fleshy
Microscopic (histologic) description
  • Fibrovascular connective tissue that migrates onto cornea, dissecting into plane of Bowman's layer leading to fragmentation
  • Similar to pinguecula but with corkscrew configuration / basophilic fibrillar degeneration of individual collagen fibers
  • Also variable acute and chronic inflammatory infiltrate and vascular congestion with feeder vessels into connective tissue
  • May cause atrophy, thickening or dysplasia of adjacent corneal epithelium
  • Goblet cell hyperplasia
Microscopic (histologic) images

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Typical histological features

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Stromal elastosis

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Atypical histological features

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Stromal plaques

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Stem cell microclusters


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H&E, E-cadherin and β-catenin

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Hsp90

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Ki67

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Cytokeratin and S100B of nevi in pterygia

Positive stains
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