Bilateral conjunctival MALT lymphoma mimicking chronic conjunctivitis

Area of Science:

• Ophthalmology
• Oncology
• Pathology

Background:

• Conjunctival lymphoid tumors typically present with a characteristic salmon-pink, pebbly appearance.
• A diffuse clinical presentation can mimic other forms of chronic conjunctivitis, potentially delaying diagnosis.

Observation:

• A 60-year-old man presented with bilateral conjunctival masses initially presumed to be chlamydial conjunctivitis.
• Despite partial response to antibiotics, symptoms recurred, prompting re-evaluation and biopsy.
• Histopathological analysis confirmed mucosa-associated lymphoid tissue (MALT) lymphoma.

Findings:

• The patient received cyclophosphamide, vincristine, and prednisolone (CVP) chemotherapy.
• After six courses, partial remission was achieved in both eyes.
• Sustained remission was maintained for 28 months post-chemotherapy.

Implications:

• A high index of suspicion is necessary for diagnosing atypical conjunctival lymphoid tumors.
• Prompt and accurate diagnosis is vital to avoid treatment delays.
• This case highlights the importance of histopathological confirmation for rare presentations of MALT lymphoma.