Lisch nodule pathophysiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Swathi Venkatesan, M.B.B.S.[2]

Pathophysiology of Lisch Nodule

  • A hamartoma is defined as a benign tumor or nodular growth that is composed of proliferating mature histologically normal cells that normally reside at the affected tissue
    • In ophthalmic jargon, iris hamartomas traditionally refer to Lisch nodules which are encountered in patients with neurofibromatosis type 1 (NF1).
  • NF1 is due to mutations in the NF1 gene, located at chromosome 17q11.2
  • Neurofibromin, the protein product encoded by the gene, is expressed in many tissues, including brain, kidney, spleen, and thymus
  • Mutations in the NF1 gene result in loss of production or reduced function of protein; this causes a wide spectrum of clinical findings, including NF1-associated tumors
  • Histopathologically, Lisch nodules are composed of melanocytes and spindle cells, usually concentrated on the superficial layers of the iris stroma. [1]
  • The spindle cells are larger than the normal iris melanocytes.
  • Immunohistochemical studies show positive reaction against vimentin, smooth muscle actin and neuron specific enolase.

References

  1. Kiratli, H (2011). "Head and Neck: Iris Hamartomas". Atlas of Genetics and Cytogenetics in Oncology and Haematology (1). doi:10.4267/2042/44673. ISSN 1768-3262.


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