Bilateral conjunctival MALT lymphoma mimicking chronic conjunctivitis.
BACKGROUND
The diagnosis of conjunctival lymphoid tu-mors is straightforward when they present with a characteristic salmon-pink, pebbly, multinodular appearance. However, rarely a diffuse clinical presentation is encountered, and this may mimic chronic conjunctivitis of other etiologies.


METHODS
A 60-year-old man was referred to our clinic with bilateral conjunctival masses in May 2005. With the assumption of chlamydial conjunctivitis, without microbiological or histopathological evidence, tetracycline ointment and oral doxycycline 100 mg twice daily were prescribed. Although a partial response was achieved, 2 months after the treatment, the patient's complaints returned. On second referral to our clinic in March 2006, the patient was re-evaluated. He presented with bilateral conjunctival masses resembling conjunctival lymphoma, and a bilateral diagnostic biopsy was performed. Histopathological evaluation of the biopsy specimens revealed mucosa-associated lymphoid tissue (MALT) lymphoma. The patient received CVP chemotherapy (cyclophosphamide, vincristine, prednisolone). After 6 courses of chemotherapy, he achieved partial remission in both eyes. Currently, 28 months after CVP, sustained remission is obtained.


CONCLUSIONS
In these cases, a high index of suspicion is required if one is to avoid a delay in diagnosis, and the importance of correct early diagnosis is obvious.
Seker
Mesut
M
Department of Medical Oncology, Dr. Lutfi Kirdar Education and Research Hospital, Istanbul, Turkey. mnseker@hotmail.com
Ozdemir
Burak
B
Bilici
Ahmet
A
Ustaalioğlu
Bala Basak
BB
Sonmez
Berkant
B
Yilmaz
Burcak Erkol
BE
Kurnaz
Ekrem
E
Gumus
Mahmut
M
Yaylaci
Mustafa
M
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D001706:Biopsy; D002908:Chronic Disease; D003228:Conjunctiva / Q000473:pathology; D003230:Conjunctival Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D003235:Conjunctivitis, Inclusion / Q000175:diagnosis*; D003520:Cyclophosphamide / Q000008:administration & dosage; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D011241:Prednisone / Q000008:administration & dosage; D012074:Remission Induction; D014750:Vincristine / Q000008:administration & dosage
D014750:Vincristine; D003520:Cyclophosphamide; D011241:Prednisone