J Korean Ophthalmol Soc.  2018 Jul;59(7):676-679. 10.3341/jkos.2018.59.7.676.

A Case of Isolated Conjunctival Lymphangioma Mimicking a Recurrent Conjunctival Cyst

• Jeon J
• Cho CH
• Lee SB

• KMID: 2416271
• DOI: http://doi.org/10.3341/jkos.2018.59.7.676

Abstract

PURPOSE
To report a case of isolated conjunctival lymphangioma mimicking a recurrent conjunctival cyst.
CASE SUMMARY
A 39-year-old male with a conjunctival cyst in the right eye lasted for 1 month visited our hospital. He had previously undergone aspiration of the cyst at another hospital 1 week before visiting our hospital. However, the cyst recurred, and he was referred to our hospital. On slit lamp biomicroscopy, yellow-colored turbid fluid and a hemorrhage were observed in the conjunctival cyst, but no specific finding was found in the fundus photography. The patient was initially treated with topical antibiotics and steroids. Three weeks later, absorption of the hemorrhage was noted, but there was no change in the size of the cyst. Therefore, surgical removal and histological examination of the cyst were performed. The histological examination revealed that the lesion was positive for CD 31 and D2-40, and the cyst was diagnosed as a cystic conjunctival lymphangioma. Thereafter, brain magnetic resonance imaging was performed to screen for orbital lymphangioma and systemic disease that could accompany a conjunctival lymphangioma. However, no specific findings were observed. There was no recurrence of the conjunctival cyst at 1 year and 6 months after surgical removal, and no other ophthalmic or systemic complication was observed.
CONCLUSIONS
An isolated conjunctival lymphangioma is a rare lesion. In the diagnosis of lymphangioma, systemic examination is recommended for the identification of comorbid diseases, such as orbital lymphangioma.

Keyword

Conjunctival cyst; D2-40 immunohistochemical staining; Isolated lymphangioma

MeSH Terms

Absorption
Adult
Anti-Bacterial Agents
Brain
Diagnosis
Hemorrhage
Humans
Lymphangioma*
Magnetic Resonance Imaging
Male
Orbit
Photography
Recurrence
Slit Lamp
Steroids
Anti-Bacterial Agents
Steroids

Figure

• 

  Figure 1 Slit-lamp photography of right eye. (A) Preoperative photography after 3 weeks of medical treatment. Yellow-colored turbid fluid was observed in the conjunctival cyst at inferonasal area. (B) On postoperative day 2, stable operation site with subconjunctival hemorrhage was noted. (C) On 1 year and 6 months after the operation, stable surface of operative site was noted with no recurrence of conjunctival cyst.

• 

  Figure 2 Cross section planes of immunohistochemical staining of the cyst. (A) In Hematoxylin-Eosin stain (×200), lymphatic proliferation and ectasia with a network of empty bloodless channels lined by flattened endothelium was seen (arrows). And large dilated lymphatics within the substantia propria of conjunctiva with the presence of many lymphocytes infiltrates were seen. (B) In D2-40 stain (×200), the dilated lymphatics stained positively with special immunohistochemical D2-40 staining (brown color).

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