Follicular conjunctivitis caused by a mantle cell lymphoma.
BACKGROUND
Lymphoma of the conjunctiva as part of a systemic disease is rare. The follicular appearance of the lymphocyte hyperplasia may mimic the clinical picture of infectious or allergic conjunctivitis. We report on a case of marked chronic follicular conjunctivitis, finally diagnosed as mantle cell lymphoma.


METHODS
A 52-year old male with a history of epiphora for one year, presented with follicular conjunctivitis in both eyes, a nodal mass in the upper right eyelid and nuchal lymphadenopathy. No infectious or allergic aetiology could be found. Conjunctival biopsy revealed a mantle cell lymphoma. Magnetic resonance tomography showed a bilateral spread into the orbital cavity. Other sites of involvement were the epipharynx and the cervical, axillary and paratracheal lymph nodes.


RESULTS
Chemotherapy with hyper-CVAD (cyclophosphamide, vincristine, doxorubicine, dexamethasone) was initiated. After 4 of 6 cycles, all clinical tumour manifestations had disappeared completely.


CONCLUSIONS
Conjunctival lymphoma may clinically resemble follicular conjunctivitis. Conjunctival biopsy may lead to early diagnosis and initiation of therapy.
Amstutz
C A
CA
Department of Ophthalmology, University Hospital, Zurich, Switzerland. christoph.amstutz@memcenter.unibe.ch
Michel
S
S
Thiel
M A
MA
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D003228:Conjunctiva / Q000473:pathology; D003230:Conjunctival Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D003231:Conjunctivitis / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D003520:Cyclophosphamide / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage; D003937:Diagnosis, Differential; D004317:Doxorubicin / Q000008:administration & dosage; D005142:Eyelid Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D005143:Eyelids / Q000473:pathology; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D020522:Lymphoma, Mantle-Cell / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009918:Orbital Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D014750:Vincristine / Q000008:administration & dosage
D014750:Vincristine; D003907:Dexamethasone; D004317:Doxorubicin; D003520:Cyclophosphamide