Question
A healthy 63 year old woman presents with a progressively enlarging mass in the right inferior orbit. Examination shows “ Salmon Patch” appearance in the fornix. The most likely diagnosis is?
| A. |
Reactive lymphoid hyperplasia
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| B. |
Conjunctival Lymphoma
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| C. |
Apocrine hidrocystoma
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| D. |
Melanoma
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Show Answer
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Correct Answer � B
Explanation
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Answer: B. Lymphoma
Explanation:Conjunctival lymphoma is an ocular surface tumor that usually appears as a painless, salmon-pink, “fleshy” patch. Although it generally has a smooth surface, it can also appear as a multinodular lesion or as follicular conjunctivitis
These lesions are usually primary extranodal B-cell neoplasms, although 10 to 30 percent are secondary tumors in patients with disseminated lymphoma. Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT-type lymphoma) is the most prevalent subtype, followed by follicular and diffuse large B-cell lymphoma
Etiologic Factors
Infectious: potential role of C. psittaci (Cp) in the pathogenesis of ocular adnexal MALT lymphoma has been suggested
Autoimmune. Chronic inflammatory conditions associated with orbital lymphoma include thyroid orbitopathy, Hashimoto thyroiditis, Sjögren syndrome, and celiac disease.5
Clinical Presentation
Conjunctival lymphoma shows a female predominance and occurs most frequently in the fifth to seventh decade of life as a salmon-pink nodular patch in the bulbar conjunctiva. Patients often have minimal symptoms, leading to an average delay of eight months between clinical onset and diagnosis. Various clinical complaints include conjunctival redness, irritation, and excessive tear production. Patients may also present with a palpable mass, ptosis, or diplopia.
Salmon patch in conjunctival lymphoma
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