Elsevier

Ophthalmology

Volume 107, Issue 1, January 2000, Pages 159-163
Ophthalmology

Article for CME Credit
Conjunctival lymphocytic infiltrates associated with Epstein-Barr virus

https://doi.org/10.1016/S0161-6420(99)00014-7Get rights and content

Abstract

Purpose

To describe the clinicopathologic features of two patients with Epstein-Barr virus (EBV) associated conjunctival lymphocytic infiltrates.

Design

Two case reports.

Methods

The clinical histories and pathologic findings of two patients with salmon-colored conjunctival infiltrates are described.

Main outcome measurements

Clinical observation and pathologic examination of conjunctival biopsy specimens with accompanying immunohistochemical staining, flow cytometric immunophenotyping, and polymerase chain reaction analysis when appropriate.

Results

One patient had ipsilateral preauricular lymphadenopathy, elevated serum EBV titers, and a unilateral reactive lymphocytic infiltrate resulting in a conjunctival mass. The other patient had bilateral conjunctival lymphocytic infiltrates causing conjunctival masses. There was an expanded clonal population of B lymphocytes in the conjunctival mass in the second patient. Both patients had EBV antigen in their conjunctival lymphocytic infiltrates.

Conclusions

Conjunctival lymphocytic lesions associated with EBV represent a spectrum of reactive infiltrates to monoclonal populations.

Section snippets

Patient 1

A 19-year-old man was evaluated for a 1-week history of a red right eye. The patient also had a painful, enlarged right preauricular lymph node and a sore throat. Ocular abnormalities were confined to his right eye. Examination showed his visual acuity to be 20/15, and a salmon-colored mass was present in the conjunctiva inferiorly involving the fornix and extending into the caruncle (Fig 1). The remainder of his examination was unremarkable. A complete blood count showed a 60% lymphocytosis,

Discussion

Epstein-Barr virus has been associated with a variety of ocular diseases, including Parinaud oculoglandular syndrome, conjunctivitis, dry eye, keratitis, uveitis, choroiditis, retinitis, papillitis, and ophthalmoplegia.1, 2, 6 There have been at least three patients previously described with conjunctival masses associated with EBV infections.3, 4, 5 Those cases are similar to our first patient, whereas our second patient is unique, having bilateral conjunctival masses and a transient monoclonal

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Supported in part by the National Institutes of Health (Department Core Grant no. EY06360), Research to Prevent Blindness, Inc., New York, NY, and the Gertrud Kusen Foundation, Bendestorf, Germany.

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