Oncocytic lesions of the ophthalmic region

Abstract

Abstract Purpose To make a nationwide clinicopathologic study of oncocytic lesions in the ophthalmic region and to characterize their cytokeratin(CK) expression. Methods All histologically diagnosed oncocytic lesions in the ophthalmic region registered in Denmark over a 25‐year period were collected and re‐evaluated using a monoclonal antimitochondrial antibody (MU213‐UC). Clinical data were registered. Immunohistochemical characterization was performed with a panel of anticytokeratin antibodies. Results A total of 34 oncocytic lesions were identified. The incidence that required surgical intervention in the Danish population could be approximated to 0.3 lesions per million capita per year. The age of the patients ranged from 45 to 89 years with a peak incidence in the 8th decade. Female gender was twice as common as male. Lesions were typically described as red‐brown, cystic and slow growing. The antimitochondrial antibody MU213‐UC produced a distinct and intense immunostaining. 26 of the lesions originated from the caruncle, three in the conjunctiva, two in the lacrimal sac, one at the semilunar plica, one on the eyelid margin and one peripunctal. Lesions were histologically classified as adenoma(oncocytoma) (26), hyperplasia (4) and metaplasia (4). Basal‐type oncocytic cells reacted with antibodies against CK5/6, CK7, CK8, CK13, CK14, CK 17, CK18, CK19 and suprabasal cells with CK4, CK7, CK8, CK18 and CK19. Antibodies against CK1+10 and CK20 showed no reaction. Conclusion Oncocytic lesions of the ophthalmic region most frequently present as a caruncular oncocytoma. The cytokeratin profile is similar to the lacrimal ‐ and accessory lacrimal gland duct elements and supports the theory that these lesions originate from lacrimal – and accessory lacrimal glands.