Primary lymphoma of the conjunctiva – a rare manifestation of indolent non-Hodgkin's lymphoma

Lymphoid tumours of the conjunctiva are extremely rare. Such tumours can appear as an isolated neoplasm or as part of a systemic disease. We describe the clinical and histopathologic findings of a patient with bilateral conjunctival lymphoma who presented with a 5-year history of chronic conjunctivitis. After clinical staging, including (1) thoracic and abdominal computerised tomography scans, (2) magnetic resonance tomography of the brain and orbita, (3) fibre-optic gastrointestinoscopy, (4) colonoscopy and (5) bone marrow biopsy, no other foci of the lymphoma were found. The patient received radiation therapy and achieved complete remission. We conclude that conjunctival lymphoma should be included in the differential diagnoses of chronic conjunctivitis. Persisting signs and symptoms of conjunctivitis not responding to standard treatment should prompt biopsy.