Dalmia Ophthalmic Pathology Services, L. V. Prasad Eye Institute, Bhubaneswar, Orissa, India.
Ophthalmology. 2013 Sep;120(9):1786-9. doi: 10.1016/j.ophtha.2013.01.071. Epub 2013 Apr 17.
To report the occurrence of actinic granuloma of the conjunctiva in young women.
Retrospective case series.
Three eyes of 3 young women with a unilateral conjunctival mass of recent onset.
Three young women (21, 23, and 23 years of age) sought treatment for painless red masses of the conjunctiva that were thought clinically to be pingueculitis, actinic keratosis, or ocular surface squamous neoplasia (OSSN), but were diagnosed histopathologically as actinic granuloma. Special stains were performed to exclude infectious and autoimmune causes of granulomatous inflammation, followed by dermatologic work-up and systemic investigations. Diagnosis of actinic granuloma of the conjunctiva was confirmed.
Patients' characteristics (age, sex, early onset), clinical presentation, same geographical location, typical histopathologic features, and lack of systemic association.
All 3 cases were in young women with a rapid-onset conjunctival growth with conjunctival feeder vessels and intrinsic vessels; however, there was no surface keratin, and rose bengal stain results were negative. Histopathologic analysis of all 3 cases revealed elastolysis and granulomatous inflammation characterized by multinucleated giant cells, some of which displayed elastophagocytosis that was highlighted by Verhoeff-van Giesen elastic stain. There was absence of cytologic atypia of surface epithelium. Mucin stains and special stains for an infectious cause demonstrated negative results. Serologic investigations and systemic work-up results were negative, which excluded any systemic associations with this condition. This led to the final diagnoses of actinic granuloma of the conjunctiva.
Conjunctival actinic granuloma is an underrecognized entity. We present 3 cases of this condition to highlight its occurrence in young women and the role of histopathologic examination to avoid misinterpretation of this condition. Both clinician and pathologist should consider this entity as a differential diagnosis of benign conjunctival lesions and OSSN.
FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
报告结膜光线性肉芽肿在年轻女性中的发生情况。
回顾性病例系列。
3 名年轻女性的 3 只眼，均为单侧结膜肿块，发病时间较短。
3 名年轻女性（21、23 和 23 岁）因无痛性结膜肿块就诊，临床诊断为翼状胬肉、光化性角化病或眼表面鳞状上皮瘤（OSSN），但组织病理学诊断为光线性肉芽肿。进行特殊染色以排除肉芽肿性炎症的感染和自身免疫原因，随后进行皮肤科检查和系统调查。诊断为结膜光线性肉芽肿。
患者特征（年龄、性别、发病早期）、临床表现、同一地理位置、典型组织病理学特征和无系统关联。
所有 3 例均为年轻女性，结膜快速生长，伴结膜滋养血管和固有血管；然而，无表面角化，虎红染色结果为阴性。所有 3 例的组织病理学分析均显示弹性溶解和肉芽肿性炎症，特征为多核巨细胞，其中一些显示弹性吞噬作用，Verhoeff-van Giesen 弹性染色可突出显示。表面上皮细胞无细胞异型性。粘蛋白染色和感染原因的特殊染色结果均为阴性。血清学检查和系统检查结果均为阴性，排除了该疾病与任何系统性疾病的关联。最终诊断为结膜光线性肉芽肿。
结膜光线性肉芽肿是一种认识不足的疾病。我们报告 3 例该疾病，以强调其在年轻女性中的发生，并强调组织病理学检查在避免对该疾病的错误解释中的作用。临床医生和病理学家都应将其作为良性结膜病变和 OSSN 的鉴别诊断。
作者没有与本文讨论的任何材料有关的专有或商业利益。
