Topical steroids eye drops in conjunctival reactive lymphoid hyperplasia: Case report.

Abstract:

RATIONALE:Conjunctival lymphoproliferative lesions constitute a significant diagnostic challenge and it is essential to exclude neoplastic lesions. Histopathological and immunohistochemical tests are very useful in establishing the correct diagnosis. Reactive lymphoid hyperplasia (RLH) is part of a spectrum of lymphocytic infiltrative disorders. Evidence is scarce regarding appropriate treatment of conjunctival RLH. We report a case treated with topical corticosteroid. PATIENT CONCERNS:A 40 year-old female presented with a 7-month history of a slow growth tumor in the superior conjunctiva of the right eye. Slit-lamp examination demonstrated salmon colored lesion in the upper conjunctiva, with little conjunctival injection, but no significant neovascularization. There was no eyelid involvement. DIAGNOSES:Ultrasound biomicroscopy showed lesion depth (1.53 mm) and larger diameter (10.73 mm). Pathological examination revealed a chronic inflammatory process with conjunctival folicular hyperplasia. The immunohistochemistry examination showed predominance of CD20, CD23, and CD 3 e CD 5. INTERVENTION:We started topic prednisolone 1% 6 times daily. OUTCOMES:Six months after starting treatment, the lesion completely resolved, without any side-effects or recurrence during three-year follow-up period. LESSONS:Conjunctival RLH can be managed in various ways, depending on patient symptonm, comorbities, and disease distribution. Surgical resection with cryotherapy, radiotherapy, systemic corticosteroids, subconjunctival triamcinolone, and rituximab are some options. There is no strong evidence in the literature of conjunctival RLH successfully treated with topical eye drops corticosteroid. In this report, we obtained completely resolution of conjunctival RLH with topical corticosteroid. CONCLUSION:Topical eye drops corticosteroids are an alternative treatment for selected cases of conjuncitval RLH with no orbital or eyelid involvement.

journal_name

Medicine (Baltimore)

journal_title

Medicine

authors

Moraes BRM,Nascimento MVDD,Neto EDDS,Santo RM

doi

10.1097/MD.0000000000008656

subject

Has Abstract

pub_date

2017-11-01 00:00:00

pages

e8656

issue

47

eissn

0025-7974

issn

1536-5964

pii

00005792-201711270-00031

journal_volume

96

pub_type

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