Primary localized conjunctival amyloidosis simulating a lymphoproliferative disorder

Area of Science:

• Ophthalmology
• Pathology
• Oncology

Background:

• Periocular amyloidosis is a rare condition that can mimic other orbital and conjunctival lesions.
• Differential diagnosis of conjunctival masses often includes lymphoproliferative disorders, potentially delaying the diagnosis of amyloidosis.

Observation:

• A 39-year-old woman presented with a 3-year history of a painless, growing left upper eyelid mass.
• Examination revealed a salmon-pink conjunctival mass, eyelid ptosis, and inferior globe displacement.
• Incisional biopsy initially suspected a lymphoproliferative process but ultimately diagnosed amyloidosis.

Findings:

• Histopathological examination confirmed amyloid deposition in the conjunctiva.
• Systemic workup excluded secondary causes of amyloidosis, such as lymphoma or multiple myeloma.
• The patient remained stable with no systemic involvement during 16 months of follow-up.

Implications:

• Localized periocular amyloidosis can present as an isolated finding without systemic disease.
• The classic salmon-pink conjunctival infiltrate, often associated with lymphoproliferative disorders, can also be indicative of amyloidosis.
• Ophthalmologists should consider amyloidosis in the differential diagnosis of atypical conjunctival masses.