Conjunctival benign reactive lymphoid hyperplasia associated with myopic scleral thinning

University of Queensland, Brisbane, Queensland, Australia
Clinical and Experimental Ophthalmology (Impact Factor: 2.35). 03/2005; 33(1):73-5. DOI: 10.1111/j.1442-9071.2004.00947.x
Source: PubMed


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 "
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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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