Case Study: April 2010

History

A 25 year old man presents with unilateral ocular irritation that has not responded to treatment.

He undergoes a conjunctival biopsy for lymphoma.

The figures show the key features.

Questions

1. What would have been the clinical appearance of this lesion?
2. What is the histological reaction pattern?
3. What is the differential diagnosis?

Click to show answers

A follicular conjunctival reaction.
A follicular conjunctivitis due to reactive lymphoid hyperplasia. Note the lymphoid follicles and the tingible body macrophages.
Adenovirus, herpes simplex, molluscum contagiosum, chlamydia infection, glaucoma and antiviral drops, mechanical irritation.

In this case, the patient had chlamydia infection.