Clinical features and prognosis of conjunctival lymphoid hyperplasia

Authors:Jie Ying,  Li Shang,  Xu Xiaolin,  Ruan Fang,  Li Bin,  Lyu Lan,  Pan Zhiqiang
DOI: 10.3760/cma.j.issn.2095-0160.2016.06.014
Published 2016-06-10
Cite as Chin J Exp Ophthalmol, 2016,34(6): 545-550.

Abstract

Background

Primary conjunctival lymphoid hyperplasia exhibit atypical clinical symptoms and easy to cause misdiagnosis and mistreatment.Understanding the clinical characteristics of primary conjunctival lymphoid hyperplasia is of an important clinical significance.

Objective

This study was to analyze the clinical characteristics and therapeutic outcome of patients with primary conjunctival lymphoid hyperplasia.

Methods

The medical records of 20 patients with primary conjunctival lymphoid hyperplasia who was treated in Beijing Tongren Hospital from January 2012 to December 2014 were retrospectively analyed.The age, symptoms, therapy, prognosis, histopathological features and immonochemistry results were reviewed, and the treating approach targeting to different types of conjunctival lymphoid hyperplasia was evaluated.The fellow-up duration was 1-2 years.

Results

Age of the patients ranged from 27 to 83 years old.The lesions were classified as benign lymphocytic hyperplasia, atypical lymphoid hyperplasia and lymphoma.Majority of lesions located in fornix conjunctiva tissue (90%). Follicle-like appearance was seen in the benign lymphocytic hyperplasia, and pink elavation was exhibited at the bulbar conjunctiva in the atypical lymphoid hyperplasia.A diffuse salmon fish like appearance in conjunctiva was the primary feature of conjunctival lymphoma.Histopathological examination showed that conjunctival benign lymphocytic hyperplasia had follicle-like tissue in lesions, atypical lymphoid hyperplasia exhibited diffuse lymphocyte filtration, and conjunctival lymphoma appeared monocyte filtration.The 3 tpyes of lesions also could be differentiated by immunochemistry.The medicine was applied in the eyes with benign lymphocytic hyperplasia, and the combination of resection of lesions with conjunctival tissue or amniotic membrane transplantation was used for the atypical lymphoid hyperplasia or lymphoma eyes.No recurrence of the lesions was found during fellow-up duration.

Conclusions

The clinical manifestations of conjunctival lymphoid hyperplasia lesions are varied, and it is easy to be confused with chronic ocular surface diseases.Pathology and immunochemistry are helpful for the differential diagnosis.The treating regimen is dependent on the lesion type.Most patients have a favorable prognosis with treatment.

Key words:

Conjunctival diseases/pathology; Conjunctival neoplasms/diagnosis & therapy; Hyperplasia; Lymphoid tissue/pathology; Lymphoma/pathology; Retrospective studies; Humans

Contributor Information

Jie Ying
Beijing Tongren Hospital, Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Science Key Laboratory, Beijing 100730, China
Li Shang
Department of Ophthalmology, Capital Medical University Beijing You’an Hospital, Beijing 100069, China
Xu Xiaolin
Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Science Key Laboratory, Beijing 100730, China
Ruan Fang
Beijing Tongren Hospital, Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Science Key Laboratory, Beijing 100730, China
Li Bin
Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Science Key Laboratory, Beijing 100730, China
Lyu Lan
Beijing Tongren Hospital, Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Science Key Laboratory, Beijing 100730, China
Pan Zhiqiang
Beijing Tongren Hospital, Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Science Key Laboratory, Beijing 100730, China
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