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Subconjunctival hemorrhages commonly occur idiopathically or from causes including ocular surgery, trauma, anticoagulation medications, or a Valsalva maneuver. When a hemorrhage persists or recurs, a more extensive list of differential diagnoses must be considered. This report details a case in which persistent subconjunctival hemorrhages led to the discovery of ocular adnexal lymphoma. CASE
A 68-year-old white man presented with a 7- to 8-month history of a recurrent red left eye. There was no associated pain, discharge, or change in vision over that time. The right eye was never involved. An ocular examination of the left eye found a mild nasal subconjunctival hemorrhage and a salmon-pink-colored lesion involving the superior conjunctiva. Clinical findings, photos, magnetic resonance images, and histopathology results are presented and reviewed. The signs, symptoms, incidence, pathophysiology, treatment, and prognosis of ocular adnexal lymphoma are also discussed.
Lymphomas can occur in a variety of sites in the body. It is well documented that primary tumors can originate in the ocular adnexa. Although not typical, the first sign in this case was a recurrent subconjunctival hemorrhage. The importance of a thorough ocular examination is paramount for a patient's ocular health and possibly the patient's life.
Veterans Affairs Palo Alto Health Care System, Palo Alto, California; San Francisco Department of Veterans Affairs Medical Center, San Francisco, California.
This article was published in the following journal.
Name: Optometry (St. Louis, Mo.)
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Subconjunctival orbital fat prolapse has been rarely described in the literature, often leading to misdiagnosis. In this article, we present the clinical features and treatment of patients with subcon...
Trabeculectomy is an ocular surgery intended to reduce intra-ocular pressure the surgery creates a sub-conjunctival filtering bleb which filters aqueous humor fluid out. A rather common a...
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The exact mechanism of the pathogenesis of Graves’ ophthalmopathy is still unknown. Histopathologically, extraocular muscle inflammation and orbital fat inflammation are two prominent ch...
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Clinically benign, histologically malignant, recurrent cutaneous T-cell lymphoproliferative disorder characterized by an infiltration of large atypical cells surrounded by inflammatory cells. The atypical cells resemble REED-STERNBERG CELLS of HODGKIN DISEASE or the malignant cells of CUTANEOUS T-CELL LYMPHOMA. In some cases, lymphomatoid papulosis progresses to lymphomatous conditions including MYCOSIS FUNGOIDES; HODGKIN DISEASE; CUTANEOUS T-CELL LYMPHOMA; or ANAPLASTIC LARGE-CELL LYMPHOMA.
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B-cell lymphoid tumors that occur in association with AIDS. Patients often present with an advanced stage of disease and highly malignant subtypes including BURKITT LYMPHOMA; IMMUNOBLASTIC LARGE-CELL LYMPHOMA; PRIMARY EFFUSION LYMPHOMA; and DIFFUSE, LARGE B-CELL, LYMPHOMA. The tumors are often disseminated in unusual extranodal sites and chromosomal abnormalities are frequently present. It is likely that polyclonal B-cell lymphoproliferation in AIDS is a complex result of EBV infection, HIV antigenic stimulation, and T-cell-dependent HIV activation.
A leukemia/lymphoma found predominately in children and young adults and characterized LYMPHADENOPATHY and THYMUS GLAND involvement. It most frequently presents as a lymphoma, but a leukemic progression in the bone marrow is common.
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