Topical Cyclosporin in the Treatment of Chronic Sarcoidosis of the Conjunctiva (original) (raw)
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Benign Reactive Lymphoid Hyperplasia of the Conjunctiva Treated With Cyclosporine
Cornea, 2017
Background/aim Our aim is to the report the clinical and histopathological features of benign reactive lymphoid hyperplasia (BRLH) of the conjunctiva in children and the outcomes of treatment. Methods A retrospective chart review was performed for children aged 0-18 years, diagnosed with conjunctival BRLH from January 2000 to December 2013 at two large ophthalmology hospitals in the Middle East. Data were collected on patient demographics, features of the lesions, the site of the lesion, location, adnexal involvement, lymph nodes involvement, local spread, histopathology and molecular genetic studies of the cases (if available), outcomes of treatment and recurrence. Results There were 24 patients with lymphoid lesions classified as conjunctival BRLH during the 12-year period evaluated in this study. The mean age at diagnosis was 11.6 years. Twenty-three patients were males (96%). Systemic medical history included three patients with bronchial asthma, one patient with Down's syndrome, one patient with generalised skeletal malformation and one patient with gastritis. The initial uncorrected visual acuity was 20/30 or better in 93.5% of the eyes. At presentation, the tumour was unilateral in 12 cases (50%). The conjunctival mass was located on the bulbar conjunctiva in all cases. The mass was present nasally in 96% of lesions. No cases (that were tested) had an infectious aetiology. PCR demonstrated monoclonality suggestive of lymphoma in two cases; however, this did not alter the final diagnosis as BRLH per histopathological criteria and clinical course, Conclusions All investigated cases of paediatric conjunctival BRLH had a benign clinical course with no local or systemic dissemination and a male predominance. Recurrence was rare, and in our cohort, it was not associated with malignant transformation.
Lacrimal Gland Involvement in Lymphomatoid Granulomatosis and Review of the Literature
2010
Objective. To describe the clinicoradiological and histopathological findings in a case of lacrimal gland enlargement secondary to lymphomatoid granulomatosis (LG) and to review the literature. Design. Case report and systematic literature review. Methods. A 75-year-old woman presented with right ptosis. Computerised tomography showed lacrimal gland enlargement, and biopsy done was inconclusive. She subsequently developed pulmonary symptoms and underwent transbronchial biopsy that was diagnosed as LG. Pub Med and OVID databases were searched using the term "orbit/eye involvement in lymphomatoid granulomatosis". Articles that predated the databases were gathered from current references. Results. The patient underwent lacrimal gland biopsy which revealed necrotic and inflamed tissue with no further categorisation but transbronchial biopsy helped in establishing the diagnosis of LG. On initiation of prednisolone and cyclophosphamide, her orbital lesion resolved but the patient died following massive pulmonary hemorrhage within a month of diagnosis. Conclusion. Ophthalmic involvement in LG is very rare. Varied presentations are due to central nervous system involvement, vasculitis, or infiltration of ocular or orbital structures. LG is an angiocentric and angiodestructive granulomatous disorder and can involve any tissue, thus accounting for the variable presentations reported in literature.
Middle East African Journal of Ophthalmology , 2024
PURPOSE: To report the clinical presentation, histopathological and immunohistological features of conjunctival lymphatic–venous lesions. METHODS: This was a retrospective review of 15 patients with symptomatic conjunctival lymphatic–venous lesions. The clinical features and histopathologic features of the excised tissues were reviewed. Immunohistochemical staining with antibodies against CD34 to label vascular endothelium and D2‑40 to label lymphatic endothelium was performed. RESULTS: All patients had unilateral conjunctival involvement. The mean age was 48.9 ± 18.9 years, with more women affected (67%). No patient had impaired visual acuity secondary to the lesion. The location of the lesion was temporal in 67% of patients. The presenting symptoms included conjunctival swelling, discomfort and/or foreign‑body sensation, and tearing. All lesions were excised, and none recurred. All excised lesions showed dilated channels that were lined by a flattened endothelium staining positive with CD34, surrounded by edematous lamina propria. Larger ectatic lymphatic channels demonstrated scattered D2‑40 staining in the endothelial cell lining and patchy CD34 staining within the endothelial cell cytoplasm. D2‑40 and CD‑34 immunoreactivity did not overlap in the same cells. CONCLUSION: The clinical features and outcomes of the lesions in this large cohort were similar to those reported in the literature. However, the mixed immunoreactivity of the endothelial cells lining these ectatic lymphatic channels in the conjunctiva suggests that these channels are lymphatic–venous lesions. We suggest that these channels be termed conjunctival lymphaticovenous malformation rather than lymphangiectasia, which suggests ectasia of existing lymphatics. Future studies are needed to understand these lesions and their histopathologic origins.
Tumors of the conjunctiva and cornea
Survey of Ophthalmology, 2004
Tumors of the conjunctiva and cornea comprise a large and varied spectrum of conditions. These tumors are grouped into two major categories of congenital and acquired lesions. The acquired lesions are further subdivided based on origin of the mass into surface epithelial, melanocytic, vascular, fibrous, neural, histiocytic, myxoid, myogenic, lipomatous, lymphoid, leukemic, metastatic and secondary tumors. Melanocytic lesions include nevus, racial melanosis, primary acquired melanosis, melanoma, and other ocular surface conditions like ocular melanocytosis and secondary pigmentary deposition. The most frequent nonmelanocytic neoplastic lesions include squamous cell carcinoma and lymphoma, both of which have typical features appreciated on clinical examination. The caruncle displays a slightly different array of tumors compared to those elsewhere on the conjunctiva, as nevus and papilloma are most common, but oncocytoma and sebaceous gland hyperplasia, adenoma, and carcinoma can be found. In this report, we provide clinical description and illustration of the many conjunctival and corneal tumors and we discuss tumor management. (Surv Ophthalmol 49:3-24,
A case of primary conjunctival follicular lymphoma presenting as nasolacrimal obstruction
Journal of Surgical Case Reports
We herein report a 76-year-old male who presented to the ophthalmology clinic after complaining from excessive lacrimation for ~6 months prior to presentation. He reports previously undergoing a nasolacrimal recanalization procedure in attempts to resolve his symptoms, but reported no improvement. On examination, a mass on the nasal conjunctiva around the medial canthus of the right eye was noted and subsequently excised. The findings support the diagnosis of low-grade follicular lymphoma. The patient was referred to radiation oncology for radiation therapy and received a total dose of 2400 cGy. Most ocular adnexal lymphomas are B-cell in origin, with follicular lymphomas being one of the rarest forms of such lymphomas. The most common translocation reported in over 85% of follicular lymphomas of the ocular adnexa is t(14; 18) (q32; q21). Traditional treatment options typically include a mix of chemical, surgical, and radio-oncological interventions.
American Journal of Ophthalmology Case Reports, 2017
To report an atypical case of cystic extranodal marginal zone B-cell lymphoma of mucosaassociated lymphoid tissue (MALT lymphoma) of lacrimal gland associated with vision loss. Observations: An 89-year-old woman was presented with a rapidly progressing proptosis, lagophthalmos, and vision loss. Endophthalmitis was also present. Computed tomography scan images showed a hyperdense mass with hypodense cystic areas occupying the superolateral orbit, which displaced the globe antero-inferiorly with optic nerve compression and stretching. An erosion to the adjacent superior and lateral orbital walls was also demonstrated. Complete tumor excision was performed via upper transconjunctival orbitotomy concurrently with enucleation. The immunohistopathological diagnosis was MALT lymphoma. Conclusions and importance: This case emphasizes the importance of considering lymphoma in the differential diagnosis of a cystic superolateral orbital mass.