Colin P Froines, Alexander D Lin, Kaivon Pakzad-Vaezi, Gordana Juric-Sekhar, Caitlin S Latimer, Kathryn P Scherpelz, C Dirk Keene, Eissa M Hanna, Michael R Banitt, Luis F Gonzalez-Cuyar
{"title":"伪装成肉芽肿性前葡萄膜炎和中葡萄膜炎的上皮细胞增生,组织病理学证据显示曾接受过 5-FU 治疗。","authors":"Colin P Froines, Alexander D Lin, Kaivon Pakzad-Vaezi, Gordana Juric-Sekhar, Caitlin S Latimer, Kathryn P Scherpelz, C Dirk Keene, Eissa M Hanna, Michael R Banitt, Luis F Gonzalez-Cuyar","doi":"10.3205/oc000245","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Highlight an unusual case of epithelial downgrowth (EDG) masquerading as granulomatous anterior and intermediate uveitis with histopathologic evidence of 5-fluorouracil (5-FU) treatment.</p><p><strong>Case description: </strong>A 33-year-old man presented after multiple corneal surgeries and neodymium-doped yttrium aluminum garnet (Nd:YAG) capsulotomies with subacute angle closure, pain, light sensitivity, and decreased vision. Exam was notable for granulomatous keratic precipitates, an opacified lens capsule, and vitreous cell/haze. An anterior chamber paracentesis was sent for 16 s (pan-bacterial) and 28 s (pan-fungal) rRNA polymerase chain reaction testing, which returned negative. Diagnostic argon laser photocoagulation was performed on the iris and lens capsule, which blanched upon laser photocoagulation, and subsequent iris biopsy confirmed the presence of epithelial downgrowth (EDG). The patient was treated with multiple injections of 5-FU with repeat biopsy demonstrating both a reduction and apparent resolution in epithelial cell burden after 5-FU.</p><p><strong>Conclusion: </strong>This case demonstrates an unusual presentation of EDG in a young patient with granulomatous anterior and intermediate uveitis, where simple office-based procedures of Argon laser photocoagulation and anterior chamber paracentesis helped aid in diagnosis and management. Histopathological examination in serial specimens demonstrated the effect of 5-FU on EGD. To our knowledge, this case is the first to describe histopathological reduction in epithelial cell burden with sustained resolution.</p>","PeriodicalId":73178,"journal":{"name":"GMS ophthalmology cases","volume":"14 ","pages":"Doc13"},"PeriodicalIF":0.0000,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11462678/pdf/","citationCount":"0","resultStr":"{\"title\":\"Epithelial downgrowth masquerading as granulomatous anterior and intermediate uveitis with histopathologic evidence of 5-FU treatment.\",\"authors\":\"Colin P Froines, Alexander D Lin, Kaivon Pakzad-Vaezi, Gordana Juric-Sekhar, Caitlin S Latimer, Kathryn P Scherpelz, C Dirk Keene, Eissa M Hanna, Michael R Banitt, Luis F Gonzalez-Cuyar\",\"doi\":\"10.3205/oc000245\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Highlight an unusual case of epithelial downgrowth (EDG) masquerading as granulomatous anterior and intermediate uveitis with histopathologic evidence of 5-fluorouracil (5-FU) treatment.</p><p><strong>Case description: </strong>A 33-year-old man presented after multiple corneal surgeries and neodymium-doped yttrium aluminum garnet (Nd:YAG) capsulotomies with subacute angle closure, pain, light sensitivity, and decreased vision. Exam was notable for granulomatous keratic precipitates, an opacified lens capsule, and vitreous cell/haze. An anterior chamber paracentesis was sent for 16 s (pan-bacterial) and 28 s (pan-fungal) rRNA polymerase chain reaction testing, which returned negative. Diagnostic argon laser photocoagulation was performed on the iris and lens capsule, which blanched upon laser photocoagulation, and subsequent iris biopsy confirmed the presence of epithelial downgrowth (EDG). The patient was treated with multiple injections of 5-FU with repeat biopsy demonstrating both a reduction and apparent resolution in epithelial cell burden after 5-FU.</p><p><strong>Conclusion: </strong>This case demonstrates an unusual presentation of EDG in a young patient with granulomatous anterior and intermediate uveitis, where simple office-based procedures of Argon laser photocoagulation and anterior chamber paracentesis helped aid in diagnosis and management. Histopathological examination in serial specimens demonstrated the effect of 5-FU on EGD. To our knowledge, this case is the first to describe histopathological reduction in epithelial cell burden with sustained resolution.</p>\",\"PeriodicalId\":73178,\"journal\":{\"name\":\"GMS ophthalmology cases\",\"volume\":\"14 \",\"pages\":\"Doc13\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-09-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11462678/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"GMS ophthalmology cases\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.3205/oc000245\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"GMS ophthalmology cases","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3205/oc000245","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
Epithelial downgrowth masquerading as granulomatous anterior and intermediate uveitis with histopathologic evidence of 5-FU treatment.
Purpose: Highlight an unusual case of epithelial downgrowth (EDG) masquerading as granulomatous anterior and intermediate uveitis with histopathologic evidence of 5-fluorouracil (5-FU) treatment.
Case description: A 33-year-old man presented after multiple corneal surgeries and neodymium-doped yttrium aluminum garnet (Nd:YAG) capsulotomies with subacute angle closure, pain, light sensitivity, and decreased vision. Exam was notable for granulomatous keratic precipitates, an opacified lens capsule, and vitreous cell/haze. An anterior chamber paracentesis was sent for 16 s (pan-bacterial) and 28 s (pan-fungal) rRNA polymerase chain reaction testing, which returned negative. Diagnostic argon laser photocoagulation was performed on the iris and lens capsule, which blanched upon laser photocoagulation, and subsequent iris biopsy confirmed the presence of epithelial downgrowth (EDG). The patient was treated with multiple injections of 5-FU with repeat biopsy demonstrating both a reduction and apparent resolution in epithelial cell burden after 5-FU.
Conclusion: This case demonstrates an unusual presentation of EDG in a young patient with granulomatous anterior and intermediate uveitis, where simple office-based procedures of Argon laser photocoagulation and anterior chamber paracentesis helped aid in diagnosis and management. Histopathological examination in serial specimens demonstrated the effect of 5-FU on EGD. To our knowledge, this case is the first to describe histopathological reduction in epithelial cell burden with sustained resolution.