Klinische, elektronenmikroskopische und histochemische Untersuchungen bei Conjunctivitis lignosa

Research paper by E. Lütjen-Drecoll, K. Sames, W. Straub, K. P. Krug

Indexed on: 01 Sep '75Published on: 01 Sep '75Published in: Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie. Albrecht von Graefe's archive for clinical and experimental ophthalmology


A case is briefly described in which a typical conjunctivitis lignosa appeared after the eye had suffered lime burns.In order to help clarify the morphological connection between mucopolysaccharide production and fiber development in the tumor tissue which occurred after the burn, samples were examined histologically, histochemically and with the use of the electron microscope.The tumor had a cartilage like consistency. Its structure could be devided into three regions. Region A is the pseudo-membrane. It has root like extensions which anchor it to the underlying tissue, and which morphologically appear partially homogeneous and partially fibrous. Blood cells and cell remnants are included in the tissue of the pseudomembrane. The histochemical examination of the pseudomembrane did not present a uniform picture. Along with small amounts of dermatan-sulfate and chondroitin-sulfate B the membrane probably contained a rather large amount of hyaluronic acid.The pseudomembrane borders on a granular tissue (Region B) which is distinguished by the wide metachromatic sheathes of the blood vessels found in it and the particularly large number of active fibroblasts along its edges. The silver impregnation method and the electronmicroscopic examination showed that the vascular sheathes consist of bundles of reticular fibers which constitute a three-dimensional network. A similar sort of sheath was observed around the fibroblasts. Chondroitin-sulfate makes up the largest fraction of the mucopolysaccharides near the fibers and appears particularly concentrated at the intersections of the fibers, although it is also diffusely distributed as well. Dermatan-sulfate (or heparan-sulfate) is found only in the mucopolysaccharide sheath of the fibers themselves.The deep region of the tumor (Region C) consists almost exclusively of blood vessels, their sprouts and the fibroblasts which, with their wide fibrous sheathes, almost fill the spaces between the blood vessels. The reticular fibers and their mucopolysaccharide sheathes have the same structure as that observed in Region B.The fact that the mucopolysaccharides did not appear in plaques but rather as bound primarily to the fibers is grounds for suggesting that a fiber development disorder, probably stemming from the pericytes and fibroblasts rich in ergastoplasm and fibrilles, could play the principle role in conjunctivitis lignosa. The cartilagen like consistency of the tumor could be a result of the arrangement of the fibers and their mucopolysaccharide sheathes.Brief remarks are included concerning the therapeutic consequences of the study.