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Updated: Jul 7, 2026
Visualizing Lymph Node Structure and Cellular Localization using Ex-Vivo Confocal Microscopy
Published on: August 9, 2019
In vivo confocal microscopy in a patient with conjunctival lymphoma
Patrizia Pichierri1, Gianluca Martone, Antonio Loffredo
1Ophthalmology and Neurosurgery Department, University of Siena, Siena, Italy.
Insights
This study introduces in vivo corneal confocal microscopy (IVCM) for diagnosing conjunctival mucosa-associated lymphoid tissue lymphoma. IVCM provides a non-invasive method for high-magnification evaluation of eye surface lesions, aiding early diagnosis.
Area of Science:
- Ophthalmology
- Oncology
- Medical Imaging
Background:
- Primary conjunctival mucosa-associated lymphoid tissue (MALT) lymphoma is a rare neoplastic condition.
- Early and accurate diagnosis is crucial for effective management and improved patient outcomes.
Observation:
- A case of conjunctival MALT lymphoma was examined using in vivo corneal confocal microscopy (IVCM).
- The conjunctival lesion presented as a salmon-pink patch.
- IVCM revealed characteristic cellular and structural changes in the conjunctival epithelium and stroma.
Findings:
- IVCM demonstrated irregular epithelial cells with blurred edges and numerous small, roundish, hyper-reflective cells within hypo-reflective spaces.
- These findings mimicked the histological profile of low-grade MALT lymphoma, with neoplastic cells and reactive follicles.
- Highly reflective cells were also observed in the deep stromal collagen fibers.
Implications:
- IVCM offers a non-invasive, high-magnification, and high-contrast method for evaluating conjunctival lesions.
- This technique shows potential utility in the early differential diagnosis of conjunctival MALT lymphoma.
- IVCM may become a valuable tool in the ophthalmologist's diagnostic armamentarium for ocular surface diseases.
Abstract:
A case of primary conjunctival mucosa-associated lymphoid tissue lymphoma studied by in vivo corneal confocal microscopy (IVCM) is described for the first time. Examination of the lower mediobulbar and forniceal conjunctiva of the left eye of a 37-year-old female patient showed a typical salmon-pink patch. IVCM examination of the conjunctival lesion showed irregular, polygonal, conjunctival bulbar epithelial cells with blurred edges and without visible nucleus. Many small, roundish, hyper-reflective cells were also seen. These cells were arranged diffusely or in nests in cyst-like hypo-reflective spaces. A few highly reflective cells were also visible among deep stromal collagen fibres. The IVCM picture recalled the histological profile of low-grade mucosa-associated lymphoid tissue lymphoma, characterized by sheets of neoplastic cells around reactive follicles. IVCM enabled non-invasive evaluation of the eye surface at high magnification and with good contrast, and could be useful for early differential diagnosis of conjunctival lesions.
