Histopathological evaluation of excised pterygium tissues

PURPOSE: The purpose of the study is to present the histopathological evaluation of the excised pterygium tissues and to investigate accompanying ocular surface pathologies.
METHODS: The histopathologic data of the patients who underwent pterygium excision between 2013 and 2024 were retrospectively evaluated. The demographic data, pterygium location, and whether the pterygium was primary or recurrent were also noted.
RESULTS: A total of 190 eyes of 190 patients were included. Mean age was 56.36±13.2 (range, 21–90) years, and the female-to-male ratio was 84/106. Pterygium was located in the nasal quadrant in all eyes (100%) and was recurrent in 20 (10.5%) of 190 eyes. The histopathological evaluation of the excised materials revealed that they were compatible with pterygium in 188 of the cases (98.9%). At pterygium materials histopathologically, epithelial hyperplasia, goblet cell hyperplasia, solar degeneration, squamous metaplasia, stromal inflammation, and proliferation in fibrovascular tissue were seen. In one case (0.5%) of 188 patients with pterygium, additionally epithelial dysplasia was seen histopathologically. The other two cases with clinically consistent with pterygium were diagnosed as limbal dermoid (0.5%) and as intramucosal nevus (0.5%) histopathologically.
CONCLUSION: Pterygium is a common lesion on the ocular surface which is triggered by ultraviolet light exposure. Although the risk of malignant transformation is very low, its relationship with sunlight exposure indicates the risk of other malignancies. As pterygium location is similar and the appearance might mimic ocular surface squamous neoplasia, histopathological examination is important to achieve a proper diagnosis.

Keywords: Epithelial dysplasia, histopathology, ocular surface squamous neoplasia, pterygium.