Conjunctival benign reactive lymphoid hyperplasia associated with myopic scleral thinning
University of Queensland, Brisbane, Queensland, AustraliaClinical and Experimental Ophthalmology (Impact Factor: 2.35). 03/2005; 33(1):73-5. DOI: 10.1111/j.1442-9071.2004.00947.x
Known causes of conjunctival salmon patches include lymphoma, amyloidosis, sarcoidosis, leukaemia and benign reactive lymphoid hyperplasia. The aetiology of benign reactive lymphoid hyperplasia is thought to be a localized reactive change induced by an irritative or antigenic stimulus. The case of benign reactive lymphoid hyperplasia reported herein occurred in a myopic patient with extremely thin sclera. The authors' hypothesis is that choroidal antigens are able to perfuse through thin sclera and act as chronic irritants to the overlying conjunctiva resulting in a lymphoid response and subsequent salmon patch formation.
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- "RLH is believed to be a consequence of a chronic inflammatory response of lymphoid cells in the lacrimal gland, conjunctiva, or lacrimal drainage system to irritating or antigenic stimuli.67 Benign RLH in a myopic patient with extremely thin sclera, led the authors to hypothesize that choroidal antigens are able to perfuse through thin sclera and act as chronic irritants to the overlying conjunctiva resulting in a lymphoid response.8 RLH has been reported to account for 10% of all conjunctival lymphoid proliferative lesions.9 "
ABSTRACT: To describe the clinical and histopathological features of ocular reactive lymphoid hyperplasia in children, and review the literature regarding this entity. In this retrospective, interventional case series, a chart review was performed of three patients diagnosed with reactive lymphoid hyperplasia. Details of clinical presentation, ocular and systemic examination findings, management and subsequent course were noted. Three children, aged 9-14 years presented with ocular adnexal masses (two unilateral and one bilateral) with 7-12 months duration. Ocular examination revealed discrete nasal conjunctival masses in two patients, and bilateral eyelid fullness and conjunctival chemosis in the third patient. Systemic evaluation and laboratory tests were normal in all patients. Orbital imaging showed lacrimal gland enlargement in one patient. Histopathological evaluation with immunohistochemical markers established the diagnosis of reactive lymphoid hyperplasia. Two patients underwent surgical excision with complete resolution. All patients have remained stable and at their last follow-up have showed no evidence of recurrence, transformation, or systemic involvement. Reactive lymphoid hyperplasia, though uncommon in children, can have a favorable outcome with timely intervention.
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ABSTRACT: We report a 70-year-old man with a salmon patch conjunctival mass diagnosed as multiple myeloma. Case report. Surgical biopsies of the salmon patch conjunctival mass and bone marrow, as well as hematologic workup for multiple myeloma were performed. Conjunctival biopsy revealed heavy myeloma cells with eccentric nuclei and basophilic cytoplasm infiltrate in the conjunctival stroma. Bone marrow biopsy and aspirate showed interstitial infiltrated by myeloma cells, which stained monoclonally for immunoglobulin G (IgG)-kappa light chains. Hematologic tests confirmed the diagnosis of multiple myeloma. Multiple myeloma is one of the causes of a salmon patch conjunctival lesion and may be included in the differential diagnosis.
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ABSTRACT: To determine if there is an increased rate of postoperative bacterial endophthalmitis after resident-performed cataract extraction relative to the reported rates of experienced surgeons. Retrospective, observational case series. The operative reports of the resident-performed cataract surgeries at San Francisco General Hospital between 1983 and 2002 were reviewed. Cases of culture-positive bacterial endophthalmitis and vitreous loss were identified. Between 1983 and 2002, three cases (0.11%) of culture-positive bacterial endophthalmitis occurred after 2718 resident-performed cataract extractions. The overall vitreous loss rate was 6.7%. Two endophthalmitis cases were acute (Staphylococcus epidermidis, Streptococcus viridans), presenting within five days of surgeries complicated by vitreous loss, and one case was delayed-onset (Corynebacterium species) after Nd:YAG posterior capsulotomy after uncomplicated cataract extraction. Despite higher rates of vitreous loss, the rate of endophthalmitis following resident-performed cataract surgery remains comparable with the rates of more experienced surgeons.
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