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01.12.2012 | Case report | Ausgabe 1/2012 Open Access

World Journal of Surgical Oncology 1/2012

Conjunctival lymphoma arising from reactive lymphoid hyperplasia

Zeitschrift:
World Journal of Surgical Oncology > Ausgabe 1/2012
Autoren:
Junichi Fukuhara, Satoru Kase, Mika Noda, Kan Ishijima, Teppei Yamamoto, Susumu Ishida
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1477-7819-10-194) contains supplementary material, which is available to authorized users.

Competing interests

The authors have no proprietary interests in any aspect of this study.

Authors’ contributions

JF, SK and MN proposed the study. JF and SK obtained images, wrote the manuscript provided and reviewed the pathological images. SI, KI and TY conducted the literature search. All authors read and approved the final manuscript.

Abstract

Extra nodal marginal zone B-cell lymphoma (EMZL) of the conjunctiva typically arises in the marginal zone of mucosa-associated lymphoid tissue. The pathogenesis of conjunctival EMZL remains unknown. We describe an unusual case of EMZL arising from reactive lymphoid hyperplasia (RLH) of the conjunctiva. A 35-year-old woman had fleshy salmon-pink conjunctival tumors in both eyes, oculus uterque (OU). Specimens from conjunctival tumors in the right eye, oculus dexter (OD), revealed a collection of small lymphoid cells in the stroma. Immunohistochemically, immunoglobulin (Ig) light chain restriction was not detected. In contrast, diffuse atypical lymphoid cell infiltration was noted in the left eye, oculus sinister (OS), and positive for CD20, a marker for B cells OS. The tumors were histologically diagnosed as RLH OD, and EMZL OS. PCR analysis detected IgH gene rearrangement in the joining region (JH) region OU. After 11 months, a re-biopsy specimen demonstrated EMZL based on compatible pathological and genetic findings OD, arising from RLH. This case suggests that even if the diagnosis of the conjunctival lymphoproliferative lesions is histologically benign, confirmation of the B-cell clonality by checking IgH gene rearrangement should be useful to predict the incidence of malignancy.
Zusatzmaterial
Authors’ original file for figure 1
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Authors’ original file for figure 2
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