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CASE REPORT
Year : 2007  |  Volume : 14  |  Issue : 1  |  Page : 37-38 Table of Contents     

Non-hodgkin's lymphoma of the conjunctiva


Anterior Segment Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia

Date of Web Publication11-Nov-2009

Correspondence Address:
Abdul-Elah Al-Towerki
King Khaled Eye Specialist Hospital, PO Box 7191, Riyadh 11462
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


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   Abstract 

The majority of lymphomas of the ocular adnexa are non-Hodgkin's B-cell lymphomas; many of which occur as primary tumors without systemic involvement. A 16-year-old Saudi male was treated at King Khaled Eye Specialist Hospital for primary non-Hodgkin's B-cell lymphoma without evidence of systemic involvement. Over a 4-year period of follow-up, there was no evidence of recurrent conjunctival tumor or systemic lymphoma development.

Keywords: adnexal tumor, B-cell lymphoma, non-Hodgkin′s lymphoma, primary conjunctival tumor, T-cell lymphoma


How to cite this article:
Al-Towerki AE. Non-hodgkin's lymphoma of the conjunctiva. Middle East Afr J Ophthalmol 2007;14:37-8

How to cite this URL:
Al-Towerki AE. Non-hodgkin's lymphoma of the conjunctiva. Middle East Afr J Ophthalmol [serial online] 2007 [cited 2019 Jun 17];14:37-8. Available from: http://www.meajo.org/text.asp?2007/14/1/37/57691

Lymphoid neoplasm may present as primary or secondary tumors of the eyelid, conjunctiva, and orbit. [1],[2],[3] The majority of lymphomas of the ocular adnexa are non-Hodgkin's B-cell lymphomas; many of which occur as primary tumors without systemic involvement. [1],[2],[3] When T-cell lymphomas occur in the orbit, they are usually a secondary manifestation of systemic involvement.


   Case Report Top


A 16-year-old Saudi boy presented to King Khaled Eye Specialist Hospital, complaining of a painless conjunctival mass in his right eye of at least 3 weeks' duration. He had no history of any medical disorders, and the review of systems was entirely negative. On examination, the visual acuity was 20/20 in both eyes. The ocular examination of both eyes was entirely normal, with the exception of a temporal conjunctival mass measuring 3 x 3 x 7 mm that protruded through the interpalpebral fissure [Figure 1].

An excisional biopsy was performed. Immunohistochemical studies confirmed the diagnosis of non-Hodgkin's B-cell lymphoma. The patient was referred to King Faisal Specialist Hospital and Research Centre for a systemic evaluation; no evidence of systemic disease was detected. Over a 4-year period of follow-up, there was no recurrence of conjunctival lymphoma and no evidence of systemic disease development.


   Discussion Top


Non-Hodgkin's B-cell lymphoma of the ocular adnexa occurs as a primary tumor that is limited without systemic involvement in 60% to 80% of cases. [2],[3],[4],[5] In cases where subsequent systemic involvement occurs, it usually takes place within the first 6 months, although it can take place many years later. [2],[3],[4],[5]

It is imperative that the ophthalmologist perform a diagnostic biopsy on all suspicious lymphoid lesions of the ocular adnexa. Immunohistochemisty can be used to differentiate the lesion from benign lymphoid hyperplasia and B-cell or T-cell lymphoma. [2],[3],[4],[5]

Once a diagnosis of adnexal lymphoma has been established, the patient must be referred to an oncologist for an evaluation of systemic involvement and staging of the disease. [4],[5] Investigations include complete blood count (CBC), chest X-ray, computed tomography (CT) or magnetic resonance imaging (MRI) examination of the thorax and abdomen, and bone marrow biopsy. If the systemic evaluation is negative, the primary orbital lymphoma is treated with localized radiotherapy.

Providing patients with long-term follow-up is essential for detecting both the recurrence of orbital disease and the development of systemic lymphoma. In the present case, there has been no evidence of recurrent conjunctival disease or systemic lymphoma development during a 4-year period of follow-up.

 
   References Top

1.Auw-Haedrich C, Coupland SE, Kapp A, et al. Long term outcome of ocular adnexal lymphoma subtyped according to the REAL classification. Revised European and American Lymphoma. Br J Ophthalmol 2001;85:63-69.  Back to cited text no. 1      
2.Coupland SE, Krause L, Delecluse HJ, et al. Lymphoproliferative lesions of the ocular adnexa. Analysis of 112 cases. Ophthalmology 1998;105:1430-1441.  Back to cited text no. 2      
3.Knowles DM, Jakobiec FA, McNally L, Burke JS. Lymphoid hyperplasia and malignant lymphoma occurring in the ocular adnexa (orbit, conjunctiva, and eyelids): a prospective multiparametric analysis of 108 cases during 1977 to 1987. Hum Pathol 1990;21:959-973.  Back to cited text no. 3  [PUBMED]  [FULLTEXT]  
4.Isaacson PG, Norton AJ. Extranodal Lymphomas. Edinburgh, UK: Churchill Livingstone; 1994.  Back to cited text no. 4      
5.Jenkins C, Rose GE, Bunce C, et al. Histologic features of ocular adnexal lymphoma (REAL classification) and their association with patient morbidity and survival. Br J Ophthalmol 2000;84:907-913.  Back to cited text no. 5  [PUBMED]  [FULLTEXT]  


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