Benign Reactive Lymphoid Hyperplasia of the Conjunctiva Treated With Cyclosporine.

PURPOSE: To describe a case of reactive lymphoid hyperplasia (RLH) of the conjunctiva responding to cyclosporine immunosuppressant monotherapy. METHODS: A 66-year-old man with a 2-year history of biopsy-proven bilateral RLH presented for dry eye evaluation with chief complaints of burning, stinging, and irritation in both eyes. After slit-lamp examination and positive findings of matrix metalloproteinase 9 in the patient's tear film, he was diagnosed with meibomian gland dysfunction and tear-insufficiency dry eye disease. The patient was subsequently treated with topical cyclosporine (ophthalmic emulsion 0.5 mg/mL two times per day) in both eyes. RESULTS: Examination at the 3-month follow-up visit revealed significant reduction of the RLH lesions bilaterally. CONCLUSIONS: This report represents the first case of benign ocular RLH responsive to topical cyclosporine therapy. We believe that cyclosporine could play a role in treating patients with benign ocular RLH and warrants further investigation to evaluate its full efficacy.

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

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.

Lymphocytoma cutis--case report.

We describe a clinical case involving a 62-year-old white male, diagnosed with lymphocytoma cutis (Spiegler-Fendt sarcoid) in the cephalic segment. The diagnosis was carried out by pathological study and confirmed by immunohistochemical panel: evidence of polyclonality. Phototherapy sessions were suggested as treatment (13 PUVA sessions, with an accumulated dose of 58.65 J/cm2 ). The improvement was partial. Thus, infiltration of triamcinolone was opted for (one intralesional infiltration every 3 weeks). After 5 sessions, satisfactory improvement was observed: regression of nearly all the lesions.

Lymphocytoma cutis - case report / Linfocitoma cutis - relato de caso

We describe a clinical case involving a 62-year-old white male, diagnosed with lymphocytoma cutis (Spiegler-Fendt sarcoid) in the cephalic segment. The diagnosis was carried out by pathological study and confirmed by immunohistochemical panel: evidence of polyclonality. Phototherapy sessions were suggested as treatment (13 PUVA sessions, with an accumulated dose of 58.65 J/cm2 ). The improvement was partial. Thus, infiltration of triamcinolone was opted for (one intralesional infiltration every 3 weeks). After 5 sessions, satisfactory improvement was observed: regression of nearly all the lesions.

Relatamos um caso de um paciente de 62 anos, branco e com diagnóstico de linfocitoma cutis (Sarcoide de Spigler-Fendt) em segmento cefálico. O diagnóstico foi confirmado pelo histopatológico e reafirmado pelo painel imuno-histoquímico: evidência de policlonalidade. Sessões de fototerapia foram propostas como tratamento: 13 sessões de PUVA cuja dose acumulada foi de 58.65 J/cm2); a melhora foi parcial. Optado, então, por infiltrações de triancinolona (uma infiltração intralesional a cada 3 semanas). Na quinta sessão, satisfatória melhora já podia ser evidenciada: regressão de quase todas as lesões.