Benign reactive lymphoid hyperplasia of the conjunctiva in childhood

Adel G. AlAkeely, Hind M. Alkatan, Adel H. Alsuhaibani, Hisham AlKhalidi, Leen Abu Safieh, Sarah E. Coupland, Deepak P. Edward

Research output: Contribution to journalArticle

Abstract

Background/aim Our aim is to the report the clinical and histopathological features of benign reactive lymphoid hyperplasia (BRLH) of the conjunctiva in children and the outcomes of treatment. Methods A retrospective chart review was performed for children aged 0-18 years, diagnosed with conjunctival BRLH from January 2000 to December 2013 at two large ophthalmology hospitals in the Middle East. Data were collected on patient demographics, features of the lesions, the site of the lesion, location, adnexal involvement, lymph nodes involvement, local spread, histopathology and molecular genetic studies of the cases (if available), outcomes of treatment and recurrence. Results There were 24 patients with lymphoid lesions classified as conjunctival BRLH during the 12-year period evaluated in this study. The mean age at diagnosis was 11.6 years. Twenty-three patients were males (96%). Systemic medical history included three patients with bronchial asthma, one patient with Down's syndrome, one patient with generalised skeletal malformation and one patient with gastritis. The initial uncorrected visual acuity was 20/30 or better in 93.5% of the eyes. At presentation, the tumour was unilateral in 12 cases (50%). The conjunctival mass was located on the bulbar conjunctiva in all cases. The mass was present nasally in 96% of lesions. No cases (that were tested) had an infectious aetiology. PCR demonstrated monoclonality suggestive of lymphoma in two cases; however, this did not alter the final diagnosis as BRLH per histopathological criteria and clinical course, Conclusions All investigated cases of paediatric conjunctival BRLH had a benign clinical course with no local or systemic dissemination and a male predominance. Recurrence was rare, and in our cohort, it was not associated with malignant transformation.

Original languageEnglish (US)
JournalBritish Journal of Ophthalmology
DOIs
StateAccepted/In press - Nov 29 2016

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Pseudolymphoma
Conjunctiva
Recurrence
Middle East
Gastritis
Ophthalmology
Down Syndrome
Visual Acuity
Molecular Biology
Lymphoma
Asthma
Lymph Nodes
Demography
Pediatrics
Polymerase Chain Reaction

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

Cite this

AlAkeely, A. G., Alkatan, H. M., Alsuhaibani, A. H., AlKhalidi, H., Safieh, L. A., Coupland, S. E., & Edward, D. P. (Accepted/In press). Benign reactive lymphoid hyperplasia of the conjunctiva in childhood. British Journal of Ophthalmology. https://doi.org/10.1136/bjophthalmol-2016-309030

Benign reactive lymphoid hyperplasia of the conjunctiva in childhood. / AlAkeely, Adel G.; Alkatan, Hind M.; Alsuhaibani, Adel H.; AlKhalidi, Hisham; Safieh, Leen Abu; Coupland, Sarah E.; Edward, Deepak P.

In: British Journal of Ophthalmology, 29.11.2016.

Research output: Contribution to journalArticle

AlAkeely, AG, Alkatan, HM, Alsuhaibani, AH, AlKhalidi, H, Safieh, LA, Coupland, SE & Edward, DP 2016, 'Benign reactive lymphoid hyperplasia of the conjunctiva in childhood', British Journal of Ophthalmology. https://doi.org/10.1136/bjophthalmol-2016-309030
AlAkeely AG, Alkatan HM, Alsuhaibani AH, AlKhalidi H, Safieh LA, Coupland SE et al. Benign reactive lymphoid hyperplasia of the conjunctiva in childhood. British Journal of Ophthalmology. 2016 Nov 29. https://doi.org/10.1136/bjophthalmol-2016-309030
AlAkeely, Adel G. ; Alkatan, Hind M. ; Alsuhaibani, Adel H. ; AlKhalidi, Hisham ; Safieh, Leen Abu ; Coupland, Sarah E. ; Edward, Deepak P. / Benign reactive lymphoid hyperplasia of the conjunctiva in childhood. In: British Journal of Ophthalmology. 2016.
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abstract = "Background/aim Our aim is to the report the clinical and histopathological features of benign reactive lymphoid hyperplasia (BRLH) of the conjunctiva in children and the outcomes of treatment. Methods A retrospective chart review was performed for children aged 0-18 years, diagnosed with conjunctival BRLH from January 2000 to December 2013 at two large ophthalmology hospitals in the Middle East. Data were collected on patient demographics, features of the lesions, the site of the lesion, location, adnexal involvement, lymph nodes involvement, local spread, histopathology and molecular genetic studies of the cases (if available), outcomes of treatment and recurrence. Results There were 24 patients with lymphoid lesions classified as conjunctival BRLH during the 12-year period evaluated in this study. The mean age at diagnosis was 11.6 years. Twenty-three patients were males (96{\%}). Systemic medical history included three patients with bronchial asthma, one patient with Down's syndrome, one patient with generalised skeletal malformation and one patient with gastritis. The initial uncorrected visual acuity was 20/30 or better in 93.5{\%} of the eyes. At presentation, the tumour was unilateral in 12 cases (50{\%}). The conjunctival mass was located on the bulbar conjunctiva in all cases. The mass was present nasally in 96{\%} of lesions. No cases (that were tested) had an infectious aetiology. PCR demonstrated monoclonality suggestive of lymphoma in two cases; however, this did not alter the final diagnosis as BRLH per histopathological criteria and clinical course, Conclusions All investigated cases of paediatric conjunctival BRLH had a benign clinical course with no local or systemic dissemination and a male predominance. Recurrence was rare, and in our cohort, it was not associated with malignant transformation.",
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