Conjunctival Lymphoma Masquerading a Chalazion in a Child

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Conjunctival Lymphoma Masquerading a Chalazion in a Child Michael Waisbourd, MD* Igal Leibovitch, MD* Dror Sayar, MD† Ronit Elhasid, MD† *Department of Ophthalmology †Pediatric Hemto-Oncology unit Tel Aviv Medical Center, Tel Aviv, Israel

Introduction Childhood conjunctival lymphoma is an extremely rare entity and may comprise a diagnostic challenge We report a case of childhood conjunctival lymphoma masquerading as an internal chalazion.

Case report A 13-year-old girl was referred to our department with a three weeks history of right lower lid forniceal mass, initially diagnosed as a chalazion

Case report On examination, a 15 millimeter elevated pink conjunctival mass was apparent in her lower fornix. The mass was surgery excised. Figure 1

Case report Figure 2A. Groups of cells containing large nuclei with scarce cytoplasm (arrow) and nucleoli (arrowhead), positive for CD20 and Ki67 staining (2B, 2C). Figure 2

Case report Polymerase chain reaction analysis of the immunoglobulin heavy chain gene rearrangement showed monoclonality of B-cells. The results were compatible with large B cell lymphoma.

Conclusions Although conjunctival lymphoma is a very rare entity in children, it should be included in the differential diagnosis of an eyelid or conjunctival mass