A Case of Follicular Lymphoma Derived from the Conjunctiva

Abs Background : Follicular lymphoma, derived from ocular adnexa as defined by World Health Organiza tion Classification of neoplastic diseases of the hematopoietic and lymphoid tissues, is quite rare in Japan. Case : A 65-year-old woman visited our clinic for treatment of a conjunctival tumor in the left eye. Findings : Incisional biopsy revealed that the lesion was a lymphoma with well-defined follicles, and it was L 26(CD20) and BCL-2 positive immunohistochemically. Flow cytometric analysis showed that more than 70% of the cells were double positive for CD10 and CD20. Southern blot hybridization demonstrated gene rearrangement bands in the immunoglobulin gene JH region. The chromosome had a translocation t (14, 18) (q32, q21). Systemic evaluation detected no other lymphoma. Conclusion : The lesion was a follicular lymphoma derived from conjunctival tissue. Additional examinations such as flow cytometric analysis, gene analysis, and chromosome examination were useful for differential diagnosis of marginal zone B cell lymphoma of mucosa associated lymphoid tissue type and benign reactive lymphoid hyperplasia.