Document Detail


Paediatric and adolescent elevated conjunctival lesions in the plical area: lymphoma or reactive lymphoid hyperplasia?
MedLine Citation:
PMID:  24162623     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To report clinical, histopathological and molecular features of 'salmon patch'-like conjunctival lesions in paediatric and adolescent patients, and discuss management of these patients and outcome.
METHODS: Patients who presented between 2000 and 2011 with a conjunctival 'salmon-patch'-like lesion in the plical area, were identified by chart review. Clinical parameters, demographic characteristics and details of ophthalmic imaging were collected, and the effect of treatment examined.
RESULTS: Eleven patients aged 6-21 years, presented with an elevated pink conjunctival mass in the plical area of one or both eyes. Nine patients underwent an excisional biopsy that histopathologically disclosed extranodal marginal zone B cell lymphoma of mucosa-associated lymphoid tissue (also termed 'MALT lymphoma') in two cases and reactive lymphoid hyperplasia (RLH) in seven cases. Molecular diagnosis showed polyclonal B cells in six patients, monoclonal B cells in two patients, and a questionable status in one patient. Systemic examination disclosed localised ocular adnexal disease in the patients with MALT lymphoma, and none had either local or systemic recurrence during follow-up. Two other patients were treated with antiallergic medication with resolution of the lesion, and were therefore diagnosed clinically with RLH.
CONCLUSIONS: It is clinically difficult to differentiate between conjunctival RLH and MALT lymphoma in the paediatric and adolescent population. Both lesions are rare in this age group, particularly MALT lymphoma. Molecular analysis of excised lesions does not always correlate with histopathology. A short treatment course with antiallergic drops may sometimes assist diagnosis without compromising the patients due to the indolent nature of lymphoma in that area.
Authors:
Gala Beykin; Jacob Pe'er; Gail Amir; Shahar Frenkel
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-10-25
Journal Detail:
Title:  The British journal of ophthalmology     Volume:  -     ISSN:  1468-2079     ISO Abbreviation:  Br J Ophthalmol     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2013-10-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0421041     Medline TA:  Br J Ophthalmol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
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