PMC6515138_01
Initial biopsy of the patient's right palpebral conjunctival lesion. (a) Low magnification overview showing expansion of the subepithelial connective tissue by coalescent nodules of lymphocytes forming a mass lesion. H&E stain. (b) Medium magnification showing a mass forming sheet of small mature monomorphic lymphocytes compatible with a neoplastic process and not the mixed lymphocyte morphology of reactive lymphoid follicles. H&E stain. (c) High magnification showing monomorphic centrocyte-like and small mature lymphocytes without mitotic figures or tingible body macrophages, indicating a low-grade lymphoma. H&E stain.
CRIOPM2019-4061368.001.jpg
PMC6515138_01_CRIOPM2019-4061368.001.jpg
fig1
On slit-lamp examination, giant papillae were identified bilaterally in the inferior conjunctival forniceal regions, notably larger and more widespread in the right eye (Figure 1). The morphology and immunophenotype, including immunoglobulin light chain restriction, were diagnostic of an extranodal marginal zone lymphoma of the mucosa-associated lymphoid tissue (MALT lymphoma) (Figure 1).