| 본문 : Purpose: Conjunctival lymphangioma is a rare venolymphatic lesion, characterized by dilation of lymphatic vessels. It may occur as an isolated lesion or, more often, represent the surface component of a deep orbital lymphangioma. The purpose of this study was to report a case of conjunctival cystic lymphangioma that was successfully treated by excisional biopsy & primary closure. Case summary: A 39-year-old male presented with a yellow-brownish, asymptomatic cystic mass of the bulbar conjunctiva in his right eye. The lesion had been detected
1 year previously and had grown since then. Prior to presentation there were
3 times of simple needle aspiration but there was recurrence of conjunctival cyst. It contained turbid yellowish fluid and it didn't accompany with another signs such as tumor bleeding or vascular tortuosity. Funduscopy revealed no tortuous vessels on the retina of both eyes. Complete excisional biopsy was performed. Histology showed a lymphatic proliferation and ectasia with a network of empty bloodless channels lined by flattened endothelium with the presence of some inflammatory infiltrates, which is consistent with the diagnosis of conjunctival lymphangioma. And special immunostains with D2-40 is useful in recognizing lymphatic endothelium. Orbital MRI for evaluating accompanied intraocular or orbital lymphangioma showed negative findings. Systemic evaluation showed no association with an upper respiratory tract infection. Excision and biopsy confirmed the nature of the lesion, and there has been no relapse to 6 months after surgery. Conclusion: We report a rare case of an isolated conjunctival cystic lymphangioma that was cofirmed by histologic findings of excisional biopsy. We emphasize the importance of evaluation of coexisting lymphangiomas. And it is also necessary to be aware of possible recurrence of the lesion in long-term follow-up. |