title: Benign reactive lymphoid hyperplasia of the conjunctiva in childhood.
abstract: Our aim is to the report the clinical and histopathological features of benign reactive lymphoid hyperplasia (BRLH) of the conjunctiva in children and the outcomes of treatment.
  
  
  
  A retrospective chart review was performed for children aged 0-18 years, diagnosed with conjunctival BRLH from January 2000 to December 2013 at two large ophthalmology hospitals in the Middle East. Data were collected on patient demographics, features of the lesions, the site of the lesion, location, adnexal involvement, lymph nodes involvement, local spread, histopathology and molecular genetic studies of the cases (if available), outcomes of treatment and recurrence.
  
  
  
  There were 24 patients with lymphoid lesions classified as conjunctival BRLH during the 12-year period evaluated in this study. The mean age at diagnosis was 11.6 years. Twenty-three patients were males (96%). Systemic medical history included three patients with bronchial asthma, one patient with Down's syndrome, one patient with generalised skeletal malformation and one patient with gastritis. The initial uncorrected visual acuity was 20/30 or better in 93.5% of the eyes. At presentation, the tumour was unilateral in 12 cases (50%). The conjunctival mass was located on the bulbar conjunctiva in all cases. The mass was present nasally in 96% of lesions. No cases (that were tested) had an infectious aetiology. PCR demonstrated monoclonality suggestive of lymphoma in two cases; however, this did not alter the final diagnosis as BRLH per histopathological criteria and clinical course, CONCLUSIONS: All investigated cases of paediatric conjunctival BRLH had a benign clinical course with no local or systemic dissemination and a male predominance. Recurrence was rare, and in our cohort, it was not associated with malignant transformation.
authors.affiliation: King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
authors.forename: Adel G
authors.initials: AG
authors.lastname: AlAkeely
authors.affiliation: Department of Ophthalmology, King Saud University Medical City, Riyadh, Saudi Arabia.|Department of Pathology, King Saud University Medical City, Riyadh, Saudi Arabia.
authors.forename: Hind M
authors.initials: HM
authors.lastname: Alkatan
authors.affiliation: Department of Ophthalmology, King Saud University Medical City, Riyadh, Saudi Arabia.
authors.forename: Adel H
authors.initials: AH
authors.lastname: Alsuhaibani
authors.affiliation: Department of Pathology, King Saud University Medical City, Riyadh, Saudi Arabia.
authors.forename: Hisham
authors.initials: H
authors.lastname: AlKhalidi
authors.affiliation: King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
authors.forename: Leen Abu
authors.initials: LA
authors.lastname: Safieh
authors.affiliation: Department of Cellular Pathology, Royal Liverpool University Hospital, UK.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Coupland
authors.affiliation: King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.|Wilmer Eye Institute, Johns Hopkins University School of Medicine, USA.
authors.forename: Deepak P
authors.initials: DP
authors.lastname: Edward
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003228:Conjunctiva / Q000473:pathology*; D003229:Conjunctival Diseases / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D019310:Pseudolymphoma / Q000175:diagnosis* / Q000453:epidemiology; D012189:Retrospective Studies; D012529:Saudi Arabia / Q000453:epidemiology; D013997:Time Factors
keywords: Conjunctiva; Neoplasia; Pathology