Conjunctival Diffuse Large B-cell Lymphoma

Abstract

Purpose: To report a case of diffuse large B-cell lymphoma of the conjunctival fornix.Case summary: A 49-year-old man visited our clinic with redness and foreign body sensation in the right inferior conjunctival fornix that had begun 20 days previously. The patient had no pain, no fever, weight loss, and no past history of chronic disease. On slit lamp biomicroscopic examination, a large, salmon-colored, raised, well-defined, mass was detected in the inferior bulbar and fornix conjunctiva. We performed excision biopsy. The soft tissue lesion was 17 × 5 × 4 mm in size. Microscopic examination identified an area of small, mature mononuclear lymphocytes and an area of lymphocytes, such as large lymphoblasts with divided nuclei and conspicuous nucleoli. On immunohistochemical staining, the diffuse large B-cell lymphoma areas were positive for CD20 and Bcl-6, negative for CD3, CD5, and CD23, and the Ki-67 positive rate was relatively high. Finally, the patient was diagnosed with diffuse large B-cell lymphoma accompanying mucosal-associated lymphoid tissue lymphoma. There were no findings suggestive of metastasis invasion from other organs. The patient underwent immunochemotherapy after excisional biopsy. No recurrence has occurred over 1-year follow-up.Conclusions: Although rare, diffuse large B-cell lymphoma should be considered in the differential diagnosis of conjunctival lymphomatous lesions.