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Topical steroids eye drops in conjunctival reactive lymphoid hyperplasia: Case report.

Abstract Conjunctival lymphoproliferative lesions constitute a significant diagnostic challenge and it is essential to exclude neoplastic lesions. Histopathological and immunohistochemical tests are very useful in establishing the correct diagnosis. Reactive lymphoid hyperplasia (RLH) is part of a spectrum of lymphocytic infiltrative disorders. Evidence is scarce regarding appropriate treatment of conjunctival RLH. We report a case treated with topical corticosteroid.
PMID
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Authors

Mayor MeshTerms

Pseudolymphoma

Keywords
Journal Title medicine
Publication Year Start




PMID- 29381940
OWN - NLM
STAT- MEDLINE
DCOM- 20180208
LR  - 20180208
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 47
DP  - 2017 Nov
TI  - Topical steroids eye drops in conjunctival reactive lymphoid hyperplasia: Case
      report.
PG  - e8656
LID - 10.1097/MD.0000000000008656 [doi]
AB  - RATIONALE: Conjunctival lymphoproliferative lesions constitute a significant
      diagnostic challenge and it is essential to exclude neoplastic lesions.
      Histopathological and immunohistochemical tests are very useful in establishing
      the correct diagnosis. Reactive lymphoid hyperplasia (RLH) is part of a spectrum 
      of lymphocytic infiltrative disorders. Evidence is scarce regarding appropriate
      treatment of conjunctival RLH. We report a case treated with topical
      corticosteroid. PATIENT CONCERNS: A 40 year-old female presented with a 7-month
      history of a slow growth tumor in the superior conjunctiva of the right eye.
      Slit-lamp examination demonstrated salmon colored lesion in the upper
      conjunctiva, with little conjunctival injection, but no significant
      neovascularization. There was no eyelid involvement. DIAGNOSES: Ultrasound
      biomicroscopy showed lesion depth (1.53 mm) and larger diameter (10.73 mm).
      Pathological examination revealed a chronic inflammatory process with
      conjunctival folicular hyperplasia. The immunohistochemistry examination showed
      predominance of CD20, CD23, and CD 3 e CD 5. INTERVENTION: We started topic
      prednisolone 1% 6 times daily. OUTCOMES: Six months after starting treatment, the
      lesion completely resolved, without any side-effects or recurrence during
      three-year follow-up period. LESSONS: Conjunctival RLH can be managed in various 
      ways, depending on patient symptonm, comorbities, and disease distribution.
      Surgical resection with cryotherapy, radiotherapy, systemic corticosteroids,
      subconjunctival triamcinolone, and rituximab are some options. There is no strong
      evidence in the literature of conjunctival RLH successfully treated with topical 
      eye drops corticosteroid. In this report, we obtained completely resolution of
      conjunctival RLH with topical corticosteroid. CONCLUSION: Topical eye drops
      corticosteroids are an alternative treatment for selected cases of conjuncitval
      RLH with no orbital or eyelid involvement.
CI  - Copyright (c) 2017 The Authors. Published by Wolters Kluwer Health, Inc. All
      rights reserved.
FAU - Moraes, Bernardo Rodrigues Mendes
AU  - Moraes BRM
FAU - Nascimento, Micael Valtoni Dantas do
AU  - Nascimento MVDD
FAU - Neto, Epitacio Dias da Silva
AU  - Neto EDDS
FAU - Santo, Ruth Miyuki
AU  - Santo RM
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Glucocorticoids)
RN  - 0 (Ophthalmic Solutions)
RN  - 9PHQ9Y1OLM (Prednisolone)
SB  - AIM
SB  - IM
MH  - Administration, Topical
MH  - Adult
MH  - Conjunctiva/*pathology
MH  - Conjunctival Neoplasms/*diagnosis
MH  - Diagnosis, Differential
MH  - Female
MH  - Glucocorticoids/administration & dosage
MH  - Humans
MH  - Immunohistochemistry
MH  - Microscopy, Acoustic/methods
MH  - Ophthalmic Solutions
MH  - Prednisolone/*administration & dosage
MH  - *Pseudolymphoma/diagnosis/drug therapy/physiopathology
MH  - Treatment Outcome
PMC - PMC5708939
EDAT- 2018/02/01 06:00
MHDA- 2018/02/09 06:00
CRDT- 2018/02/01 06:00
PHST- 2018/02/01 06:00 [entrez]
PHST- 2018/02/01 06:00 [pubmed]
PHST- 2018/02/09 06:00 [medline]
AID - 10.1097/MD.0000000000008656 [doi]
AID - 00005792-201711270-00031 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Nov;96(47):e8656. doi: 10.1097/MD.0000000000008656.