J Korean Ophthalmol Soc.  2008 Jul;49(7):1165-1172. 10.3341/jkos.2008.49.7.1165.

Two Cases of Conjunctival Mucosa-associated Lymphoid Tissue (MALT) Lymphomas Treated by Cryotherapy

• Chang WS
• Park JB
• Kim KH
• Kim SY

• KMID: 1476973
• DOI: http://doi.org/10.3341/jkos.2008.49.7.1165

Abstract

PURPOSE
To report two cases of conjunctival mucosa-associated lymphoid tissue (MALT) lymphomas treated with cryotherapy.
CASE SUMMARY
Two patients with MALT lymphoma of the conjunctiva were treated by carbon dioxide cryotherapy under topical anesthesia using 0.5% proparacaine hydrochloride (Alcaine(R), Alcon). Cryotherapy was repeated in recurrent lesions up to three times. One patient was free of the tumor for 18 months of follow-up after the third cryotherapy was performed. The second patient had complete disease arrest for 9 months after the third cryotherapy. Neither patient experienced complications during the follow-up period.
CONCLUSIONS
Cryotherapy is a comparatively easy treatment tool with fewer complications for patients, making it preferable from a patient's perspective as well. Cryotherapy may be a useful treatment modality in patients with MALT lymphomas localized to the conjunctiva.

Keyword

Conjunctiva; Cryotherapy; MALT lymphoma

MeSH Terms

Anesthesia
Carbon Dioxide
Conjunctiva
Cryotherapy
Follow-Up Studies
Humans
Lymphoid Tissue
Lymphoma
Lymphoma, B-Cell, Marginal Zone
Propoxycaine
Carbon Dioxide
Propoxycaine

Figure

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  Figure 1. Case 1. External photograph of a 28-year-old woman with swelling of both lower eyelids.

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  Figure 2. Case 1. Photographs of the right (A) and left (B) eyes show salmon-patched lesions at the inferior forniceal conjunctiva.

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  Figure 3. Case 1. (A) Microscopic examination of conjunctival mass shows massive proliferation of atypical lymphocytes in the conjunctival stroma with invasion of overlying conjunctival squamous epithelium (H&E stain, ×400). (B) Immunohistologic staining for CD20 shows conspicuous positivity of the atypical B lymphocytic cells in the conjunctival stroma (×400).

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  Figure 4. Case 1. Photograph of the left eye during cryotherapy

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  Figure 5. Case 1. Photographs of the right (A) and left (B) eyes showing the regression of conjunctival MALT lymphomas at the last follow-up.

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  Figure 6. Case 2. Photographs of salmon-patched conjunctival lesions of the left superior (A) and inferior fornices (B).

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  Figure 7. Case 2. (A) Microscopic examination of conjunctival mass shows the massive proliferation of anaplastic lymphocytic cells in the conjunctival stroma. (H&E stain, ×200). (B) Immunohistologic staining for CD20 shows the infiltration of tumor cells originated from B lymphocytes in the overlying squamous epithelium (×400).

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  Figure 8. Case 2. Photograph of the left eye during cryotherapy

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  Figure 9. Case 2. Photograph of the left eye showing the regression of conjunctival MALT lymphomas at the last follow-up.

Reference

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