Abstract
Purpose :
Conjunctival intraepithelial neoplasia (CIN) consists of a spectrum of epithelial lesions without invasion of substantia propria or Bowen’s layer, located in the conjunctiva with possible extension to the cornea. It is predominant in light-skinned men over 50 and is associated with UV exposure. CIN is classified by the degree of atypia (mild/grade I, moderate/grade II, and severe/grade III) and encompasses the diagnosis of carcinoma in situ (CIS). The aim of this study is to analyze the epidemiological data and emphasize the importance of pathology, early detection, and monitoring.
Methods :
A retrospective analysis was performed on 250 specimens obtained between 1993 and 2023 from the MUHC-McGill University Ocular Pathology & Translational Research Laboratory. Demographic information such as sex, location, and clinical diagnosis was collected when available and patients were excluded if the CIN grading was missing.
Results :
From the 250 lesions, 7 were classed as CIS where the average age was 76 years old, 57% (n=4) were males and 86% (n=6) were in the right eye. The other 243 cases were classified as CIN where 70% (n=171) were mild, 15% (n=37) were moderate and 14% (n=35) were severe. In addition, 47% (n=115) had actinic damage, 23% (n=57) had acanthosis of the epithelium, 14% (n=35) had inflammation, 5% (n=11) had mitotic figures, and 4% (n=9) had fibrosis of the stroma. In terms of demographics, the average age was 60 years old with 53% (n=130) of the patients being male and 53% (n=123/231) of the cases occurring in the right eye. These 243 cases were subdivided into categories where they were classified as CIN, CIN from pterygium or pinguecula, from actinic keratosis (AK), and from squamous cell papilloma. Moreover, 14 of the 250 patients had at least one recurrence with 4 having bilateral presentation. Three of the 250 patients had a recurrence in the form of CIS, 4 had progression to squamous cell carcinoma (SCC), and 2 patients had an exenteration.
Conclusions :
CIN represents a spectrum of lesions that if left untreated may progress to invasive squamous cell carcinoma. This large series illustrates the prevalence of various epidemiological and histopathological features in CIN and the importance of the histopathological diagnosis for the detection of the degree of atypia and identification of high-risk patients.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.