Conjunctival posttransplantation lymphoproliferative disorder.
OBJECTIVE
To describe a patient with conjunctival posttransplantation lymphoproliferative disorder (PTLD).


METHODS
Interventional case report.


METHODS
A 8-year-old boy, three months status post bone marrow transplantation with bilateral enlarged gelatinous bulbar conjunctiva was examined. Biopsy of the bulbar conjunctiva was performed.


RESULTS
Conjunctival biopsy revealed a polymorphous infiltrate of lymphoid cells with large atypical immunoblastic lymphoma cells, plasmacytoid lymphocytes, and plasma cells. B-cell markers CD20 and CD79a were positive. Plasma cells exhibited restriction for kappa immunoglobulin light chain and were positive for CD79a. Most cells were positive for Epstein-Barr virus (EBV) encoded ribonucleic acid. EBV-related polymorphic PTLD was diagnosed and treated with discontinuation of cyclosporine, reduction in prednisone dosage and administration of EBV-specific cytotoxic T lymphocytes. The conjunctival lesions resolved during the next five weeks.


CONCLUSIONS
Posttransplantation lymphoproliferative disorder rarely involves the ocular structures with most cases presenting as a masquerade syndrome. This case illustrates that PTLD can involve the conjunctiva and further expands the clinical spectrum of ocular PTLD.
Walton
R Christopher
RC
Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee College of Medicine, Memphis, Tennessee 38163, USA. cwalton@utmem.edu
Onciu
Mihaela M
MM
Irshad
Farhan A
FA
Wilson
Terry D
TD
D015415:Biomarkers / Q000378:metabolism; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002648:Child; D003229:Conjunctival Diseases / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism; D016572:Cyclosporine / Q000008:administration & dosage; D004279:DNA, Viral / Q000097:blood; D020031:Epstein-Barr Virus Infections / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism; D015828:Eye Infections, Viral / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism; D006801:Humans; D007124:Immunoenzyme Techniques; D017403:In Situ Hybridization; D008232:Lymphoproliferative Disorders / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism; D008297:Male; D011241:Prednisone / Q000008:administration & dosage; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology; D014923:Wiskott-Aldrich Syndrome / Q000601:surgery
D015415:Biomarkers; D004279:DNA, Viral; D016572:Cyclosporine; D011241:Prednisone