Conj lymphma clinic app.
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This document presents a case of a 57-year-old male patient presenting with a painless bulbar conjunctival lesion measuring 1cm x 1cm. Differential diagnoses discussed include benign causes such as reactive lymphoid hyperplasia and conjunctival naevus, and malignant tumors including squamous cell carcinoma and amelanotic melanoma. Clinical approach involves examining factors like duration, progression, and associated symptoms. Investigations may include ultrasound biomicroscopy, CT, MRI, and biopsy if malignancy is suspected. Conjunctival lymphoma is discussed as a possible diagnosis that usually appears as a painless, salmon-pink patch and management involves work-up with an oncologist and eye-radiation therapy
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OFTALMO -NOTES.pptx
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- Physical examination includes assessing vision, eye movements, proptosis, pupil function, and examining the orbit, eyelids and anterior/posterior segments for signs of infection or complications.
- Early diagnosis and treatment with intravenous antibiotics is important to prevent vision loss or life-threatening intracranial infections.
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Evaluation of White Pupillary Reflex FINAL.pptx
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[1] Ocular Surface Squamous Neoplasia (OSSN) refers to a spectrum of dysplastic and malignant squamous lesions of the conjunctiva and cornea.
[2] Diagnosis is usually clinical but can be confirmed with biopsy. For suspected OSSN less than 3 clock hours, excision biopsy with cryotherapy and alcohol epitheliectomy is performed. Larger lesions may require chemoreduction with topical chemotherapy prior to surgery and cryotherapy.
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Conj lymphma clinic app.
- 1. Case Presentation Clinical Approach Dr. Niwar Ameen Duhok Eye Hospital 2018
- 2. History • 57 year old • Male • C.C : ordinary eye examination • Important +ve & -ve Findings : Ocular - VA 6/12 BCVA 6/6 - Painless bulbar conjunctival lesion 1cm x 1cm - No Cataract - Posterior Segment examination, normal - No Hx of ocular surgery and trauma Systemic involvement -ve -ve Medical Hx
- 3. • Make Effective Presentations • Using Awesome Backgrounds • Engage your Audience • Capture Audience Attention
- 4. What could be the DDx of conjunctival mass??
- 5. DDX Benign causes: • Benign reactive lymphoid hyperplasia • Conjunctival naevus • Benign ocular surface tumors (squamous papilloma, pyogenic granuloma, and lymphangiectasis), Malignant tumors • SCC and amelanotic melanoma Inflammatory causes: • Scleritis, episcleritis Others causes • Presence of a foreign body, amyloid deposition • Chronic follicular conjunctivitis
- 6. Clinical approach • Age • Duration (acute, chronic) • Progression (slow, rapid) • Associated symptoms (irritation, pain, discomfort) • History of Surgeries • History of Trauma • Medical Hx of (immunosuppression or malignancy)
- 7. Examination What to be looked for?
- 8. Findings • 4S (Site, Size, Shape, Surface) • Any feeder vessel ? • Exact anatomic location (conj, subconj or episec) • Extent of the lesion 1. IO involvement 2. Orbital extension 3. Lymph node spread
- 9. Investigations When and what to be done?
- 10. High index of suspicion
- 11. • Nothing if diagnosis is going with benigns • If malignantly suspicious then do the following 1. US biomicroscopy, gonioscopy to assess IOcular 2. CT, MRI to assess Iorbital 3. Biopsy : - • Whenever Lymphoma is suspected • Both eyes should biopsied even uninvolved eye from inferior fornix
- 12. Conjunctival lymphoma • 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
- 13. Salmon color
- 16. Conj lymphoma chronic Follicular conjunctivitis
- 18. Conjunctival naevus - Typically in 1st and 2nd decade - Pigmentation is variable
- 19. Conjunctival Papilloma - Strongly associated with HPV infection type 6-11 - Location (limbal, fornix or caruncle) - Prominent feeder vessel
- 20. Amelanotic conjunctival melanoma - 75% arise from PAM - 6th decade presentation
- 21. OSSN - a spectrum of benign, pre-malignant and malignant slowly progressive epithelial lesions of the conjunctiva and cornea. - Older adults are usually affected unless a predisposing systemic condition is present. - Risk factors include UV light exposure, a pale complexion, ciclosporin, smoking, petroleum product exposure, (AIDS) and xeroderma pigmentosum.
- 22. • Conjunctival lymphoma may arise • de novo • extension from orbital lymphoma • associated with systemic lymphoma at diagnosis (up to 30%). • Most conjunctival lymphomas are of B cell origin, arising from mucosa associated lymphoid tissue (MALT) and tending to be indolent.
- 23. Management • Work-up with oncologist • Rx : EBRT is the treatment of choice.