CONJUNCTIVAL MARGINAL ZONE LYMPHOMA IN A PATIENT WITH NEUROFIBROMATOSIS TYPE 1: A CASE REPORT
Published 2025 - 29th ESCRS Winter Meeting
Reference: PO219 | Type: Presented Poster & Poster | DOI: 10.82333/ph6f-4732
Authors: Maria Evanthia Sotirianakou* 1 , Evaggelia Aissopou 2 , Maria Emmanouela Savvidi 1 , Evangelia Papakonstantinou 1 , Ilias Georgalas 1 , Konstantinos Droutsas 1
1First Department of Ophthalmology , General Hospital of Athens ''G.Gennimatas'',National and Kapodistrian University of Athens,Athens,Greece, 2Macula Center,Department of Ophthalmology,Athens,Greece
Purpose
We present an interesting case of bulbar conjunctival mass due to B-cell non-Hodgkin lymphoma (NHL), without systemic involvement, in a 76-year-old man. It is crucial to recognize that a conjunctival insult might emerge in neurofibromatosis type 1 (NF1) patients.
Setting
A male aged 76, with a medical history of NF1,was referred to our department with a painless bulbar conjunctival mass in his left eye that had developed over the past six months. The patient had led a relatively healthy life with only mild effects from NF1.
Methods
The patient underwent detailed clinical examination. An excision biopsy was conducted, followed by histopathologic examination and immunohistochemistry that confirmed the diagnosis, prompting a referral for hemato-oncological assessment. The patient also underwent comprehensive laboratory and imaging scans, subsequently receiving combined chemo-immunotherapy that resulted in complete remission to date.
Results
Upon examination a mass originating from the upper nasal bulbar conjunctiva was observed, extending over the adjacent limbus and peripheral cornea, accompanied by diffuse hyperemia .The patient underwent an orbit and brain MRI which confirmed a homogenous, unifocal mass with smooth ocular margins. A meticulous dissection of the conjunctiva was employed to separate the tumor, followed by a wide excision with some margins, extending to the equator. A perilimbal area was then covered with an amniotic membrane patch, secured with fibrin glue and a 10.0 nylon suture .Following resection, the lesion was sent for histological and immunophenotypical analysis. The results confirmed a low-grade B-cell NHL consistent with conjunctival extranodal marginal zone B-cell lymphoma (EMZL) with plasmacytoid differentiation. A referral to hemato-oncology was planned.
Conclusion
Although NF1 patients have a 5- to 10- fold increase in relative risk of NHL,there have been no reported cases of conjunctival involvement in terms of NHL so far. This case is noteworthy, emphasizing the significance of considering lymphoma diagnosis in NF1 patients presenting with an orbital mass.