Department of Ophthalmology and Visual Science, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
Department of Anatomical Pathology, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
BMC Ophthalmol. 2022 Mar 26;22(1):142. doi: 10.1186/s12886-022-02370-6.
A hypertrophic limbal mass lesion is an uncommon finding of vernal keratoconjunctivitis; it normally occurs in eyes with severe papillae formation in the tarsal conjunctiva. We present a case with a limbal mass lesion in a patient with relatively mild allergic findings in the tarsal conjunctiva.
A 12-year-old Japanese boy displaying allergic conjunctivitis presented with a mass lesion at the inferior limbus in the left eye. Relatively mild papillae formation was found on the tarsal conjunctiva in both eyes. We diagnosed that the mass lesion resulted from limbal vernal keratoconjunctivitis and resected it for therapeutic purposes. Histopathological examination showed that eosinophils, lymphocytes, and fibroblasts were present in the subepithelial lesion and the substantia propria of the mass lesion. Immunohistochemical staining detected diffuse and rich infiltration of CD3-positive T lymphocytes and a relatively small number of CD20-positive B lymphocytes and CD138-positive plasma cells that tended to aggregate. The histopathologic features suggested that the limbal mass lesion had similar structures to the papillae at the tarsal conjunctiva of vernal keratoconjunctivitis.
The limbal mass lesion as a finding of vernal keratoconjunctivitis can occur even if the papillae formation at the patient's tarsal conjunctiva is mild.
角膜缘肥厚性肿块病变是春季角结膜炎的一种罕见表现；它通常发生在伴有严重的跗结膜乳头形成的眼中。我们报告了一例角膜缘肿块病变的病例，该病例患者的跗结膜仅有相对轻度的过敏表现。
一名 12 岁的日本男孩，患有过敏性结膜炎，左眼出现角膜缘肿块病变。双眼的跗结膜均有相对轻度的乳头形成。我们诊断该肿块病变是由角膜缘春季角结膜炎引起的，并为治疗目的切除了它。组织病理学检查显示，上皮下病变和肿块实质中存在嗜酸性粒细胞、淋巴细胞和成纤维细胞。免疫组织化学染色显示，CD3 阳性 T 淋巴细胞弥漫且丰富浸润，CD20 阳性 B 淋巴细胞和 CD138 阳性浆细胞数量相对较少，且倾向于聚集。组织病理学特征表明，角膜缘肿块病变与春季角结膜炎的跗结膜乳头具有相似的结构。
即使患者的跗结膜乳头形成轻微，角膜缘肿块病变也可能是春季角结膜炎的表现。
