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Garcia MD, Salomao DR, Marmorstein AD, et al. Histopathologic Findings in the Areas of Orange Pigment Overlying Choroidal Melanomas. Transl Vis Sci Technol. 2016;5(3):4doi: 10.1167/tvst.5.3.4.
Garcia, M. D., Salomao, D. R., Marmorstein, A. D., & Pulido, J. S. (2016). Histopathologic Findings in the Areas of Orange Pigment Overlying Choroidal Melanomas. Translational vision science & technology, 5(3), 4. https://doi.org/10.1167/tvst.5.3.4
Garcia, Maria D, et al. "Histopathologic Findings in the Areas of Orange Pigment Overlying Choroidal Melanomas." Translational vision science & technology vol. 5,3 (2016): 4. doi: https://doi.org/10.1167/tvst.5.3.4
Garcia MD, Salomao DR, Marmorstein AD, Pulido JS. Histopathologic Findings in the Areas of Orange Pigment Overlying Choroidal Melanomas. Transl Vis Sci Technol. 2016 May 12;5(3):4. doi: 10.1167/tvst.5.3.4. eCollection 2016 May. PMID: 27190699; PMCID: PMC4867953.
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Transl Vis Sci Technol. 2016 May 12;5(3):4. doi: 10.1167/tvst.5.3.4. eCollection 2016 May.

Histopathologic Findings in the Areas of Orange Pigment Overlying Choroidal Melanomas.

Translational vision science & technology

Maria D Garcia, Diva R Salomao, Alan D Marmorstein, Jose S Pulido

Affiliations

  1. Department of Mayo Medical School, Mayo Clinic, Rochester, MN, USA.
  2. Department of Anatomic Pathology, , Mayo Clinic, Rochester, MN, USA.
  3. Department of Ophthalmology Research, Mayo Clinic, Rochester, MN, USA.
  4. Department of Ophthalmology, Mayo Clinic, Rochester, MN, USA ; Department of Molecular Medicine, Mayo Clinic, Rochester, MN, USA.

PMID: 27190699 PMCID: PMC4867953 DOI: 10.1167/tvst.5.3.4

Abstract

PURPOSE: Orange pigment is an important sign of malignancy in melanocytic tumors. There is a question as to whether the pigment accumulation is inside of macrophages or retinal pigment epithelial (RPE) cells. We investigated which cells are involved with this color alteration.

METHODS: We examined enucleated specimens from two patients with choroidal melanoma and dense orange pigment on fundus examination. Color fundus and fundus autofluorescence (FAF) photographs were reviewed followed by examination with fluorescent microscopy, electron microscopy, and immunohistochemistry of enucleated eyes for the specific areas corresponding to the orange pigment.

RESULTS: Orange pigment was observed on color fundus photography and correlated with areas of hyperautofluorescence on FAF. Fluorescent microscopy of sections of the enucleated eyes showed autofluorescence in the RPE, which were most pronounced where there was a localized retinal detachment and reactive hyperplasia of the RPE. Immunohistochemical studies were done with keratin (OSCAR and AE1/AE3) and S-100 stained RPE cells, which still were attached to Bruch's membrane. Histiocytes present in the detached retina stained with anti-CD163 antibody and did not show autofluorescence. Electron microscopy studies of the same areas showed the presence of lipofuscin and melanolipofuscin within the clustered RPE cells.

CONCLUSIONS: Orange pigment in choroidal melanocytic lesions originates from the RPE cells, rather than macrophages, and is most abundant where there is proliferation of the RPE.

TRANSLATIONAL RELEVANCE: The orange pigment tumoral biomarker arises and is in the retinal pigment epithelium.

Keywords: choroidal melanoma; lipofuscin; melanin; melanolipofuscin; orange pigment; retinal pigment epithelium; uveal melanoma

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