PMC3420569_01
(A) Clinical photo with a well-circumscribed brownish nodule at the left lower eyelid. (B) Gross examination of the bisected tumor with a circumscribed dark cyst within the tarsus.
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fig1
A 63-year-old patient was referred with a small painless nodular tumour of his left lower eyelid (Figure 1(A)). After bisecting the specimen, gross examination revealed a dark cystic lesion in the region of the tarsus (Figure 1(B)).
(A) Microscopic view showing a hemorrhagic cyst with proliferations into the lumen (single arrow) as well as in the adjacent tissue (double arrow) (H&E, 10x). The cells are pleomorphic and atypical (insert; H&E, 40x). (B) The tumor cells are strongly positive for CK18 indicating its "simple" epithelial nature (10x). (C) With anti-Ki67 a high proliferative activity is seen within the luminal part of the tumor (big arrow; 10x) as well as in the adjacent tumor nodule (small arrow; 10x).
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fig2
However, deeper sections displayed focal proliferations of the lining epithelium into the lumen (Figure 2(A)). In contrast, CK18 (Figure 2(B)) was solely expressed by the epithelium of glandular origin including the tumour cells and to a lesser degree by the conjunctival epithelium. Ki67 was positive in about 30% of the tumour cells (Figure 2(C)) and in basal cells of the epithelium.