A rare case of primary unilateral conjunctival small lymphocytic lymphoma: A case report

Orbital lymphomas, are extranodal lymphomas primarily involving the ocular adnexa, which includes conjunctiva, eyelids, eyelashes, eyebrows, lacrimal glands, retro-orbital soft tissues, and the extraocular muscles. Ocular adnexal lymphomas can be primary or secondary. This case is important because there are few case reports in the world, and it is among the first case to be reported from Ethiopia.

Our case is a 32-year-old female patient from the Ethiopia who has presented with painless slowly growing conjuctival mass over the left eye. Histopathologic and IHC examination confirm the diagnosis of primary conjuctival small lymphocytic lymphoma (SLL).

The majority of Ocular adnexal lymphomas are unilateral, with bilateral lesions occurring in about 7 %-24 % of all cases. Ocular adnexal lymphomas are mostly low-grade B-cell non-Hodgkin lymphomas, with approximately half being extranodal marginal zone B-cell lymphomas, with small lymphocytic lymphomas being much less common. The treatment options include radiotherapy, immunotherapy, chemotherapy, or a combination of these treatments. The gold standard treatment of isolated conjunctival lymphoma after resection is localized external-beam radiation therapy.

SLLs of the ocular adnexa are rare, especially in the conjunctiva, with few cases reported in the published literature. The treating physician's should consider primary lymphomas are a possible cause of salmon colored mass in the conjunctiva specially those having history of chronic conjunctivitis. Histopathology with immunohistochemistry confirms the diagnosis of ocular lymphoma.