J Korean Ophthalmol Soc.  2012 Sep;53(9):1330-1333. 10.3341/jkos.2012.53.9.1330.

A Case of Conjunctival Hemorrhagic Lymphangiectasia

• Wang DH
• Chung JK
• Choi KS

• KMID: 2216088
• DOI: http://doi.org/10.3341/jkos.2012.53.9.1330

Abstract

PURPOSE
To report a case of hemorrhagic lymphangiectasia treated with surgical excision and confirmed by pathologic examination.
CASE SUMMARY
A 21-year-old man presented with spontaneous hyperemia of his right eye of 1 week duration. The patient had a history of tuberculous retinal vasculitis and uveitis 1 year prior, but there was no active lesion during regular follow-up. There was no history of trauma, visual disturbance, diplopia, ocular pain, or any sign of systemic disease. Slit lamp examination showed tortuous dilatation of blood-filled lymphatic vessels on temporal conjunctiva of the right eye. The lesion did not change during the 4 weeks of follow-up and local excision biopsy was made for final diagnosis and treatment. Pathologic examinations revealed thin-walled lymphatic vessels with localized dilatation which contained blood in the lumen consistent with hemorrhagic lymphangiectasia. There was no sign of recurrence until 2 months after the operation.
CONCLUSIONS
Hemorrhagic lymphangiectasia should be considered in patients with recurrent or longstanding localized tortuous subconjunctival hemorrhage.

Keyword

Conjunctiva; Hemorrhage; Hemorrhagic lymphangiectasia; Lymphatic vessel

MeSH Terms

Biopsy
Conjunctiva
Dilatation
Diplopia
Eye
Follow-Up Studies
Hemorrhage
Humans
Hyperemia
Lymphatic Vessels
Recurrence
Retinal Vasculitis
Uveitis
Young Adult

Figure

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  Figure 1 Slit lamp photograph shows tortuous dilatation of conjunctival lymphatic vessels which are segmentally filled with blood, with accompanying subconjunctival hemorrhage.

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  Figure 2 Postoperative slit lamp photographs. (A) Conjunctiva with dilated hemorrhagic lymphatics was excised and the defect was covered with 6.0 × 6.0 mm sized conjunctival autograft. (B) Photograph two months after treatment shows little conjunctival scar but no lymphatic dilatation or subconjunctival hemorrhage.

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  Figure 3 Hemorrhagic lymphangiectasia. (A) Pathologic examination after conjunctival excisional biopsy shows localized dilatation of lymphatic vessels (arrow) (hematoxylin-eosin, ×40). (B) The dilated lymphatics have thin vessel wall and contain blood in the lumen (hematoxylin-eosin, ×200).

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