Article
The proof of intraepithelial mucous cysts in the conjunctival epithelium
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Published: | September 22, 2004 |
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Outline
Text
Objective
Intraepithelial mucous cysts developed from cystic goblet (mucus secreting) cells or cystic muzin crypts. Their incidence in the normal human conjunctiva was proved by histological specimen (Kessing 1969). By conjunctival cytology examinations the mucous cysts were mentioned once up to now (Bizarri et al. 1999). We analyzed cytological surface samples of healthy persons and of glaucoma patients under topographically anatomic aspects.
Methods
There were received 240 cytological conjunctival samples of 40 probands by the impression cytology. We noticed the tapping point and the technique was standardized all the time: the same surface pressure (15CN), 6 samples per examination.
Results
Intraepithelial mucous cysts are also realized by the impression cytology by knowledge of the morphological structure. The characteristic morphology with numerous mucus secreting goblet cells as an optic empty area or PAS-positive cystic structure can be seen, interspersed between the polygonal arranged non-secreting epithelial cells. The interepithelial mucous cysts of conjunctiva bulbi were mainly far from the limbus and in superior quadrants (50%), rarely in inferior quadrants (20%), no cysts in the lid slit. The recognizability and the demarcation of the cysts decrease with shift of the nucleus plasma relation and expansion of intracellular areas. A meaning is that the cysts developed by stagnation of normal mucus secreting goblet cells caused by epithelial changes. The impression cytology samples show that normal non-secreting epithelial cells are nearly of these cysts.
Conclusions
Intraepithelial mucous cysts are not only traceable in histological specimen of conjunctiva also in cytological samples. There could be an false interpretation of the cysts because of the very detailed image analysis. If there are insufficient correlations between clinical signs, functional test of tear film and the impression cytology mucous cysts should be respect in the future.
Bizzarri, B., Fiore, A., Missiroli, A. Intraepithelial mucous cysts. A new parameter for the evaluation of conjunctival impression cytology specimes. SOE 1999
Kessing, S.V. Epithelial cysts in the conjunctiva. Acta ophthalmol 47 (1969): 642-654