More than meets the eye: The 'pink salmon patch'

Abstract

Ocular adnexal lymphomas account for 1-2% of all non-Hodgkin's lymphomas. Conjunctiva is the primary site of involvement in one-third of cases. We present a case of a 47-year-old Hispanic woman who presented with left eye itching and irritation associated with a painless pink mass. Physical examination revealed the presence of a 'pink salmon-patch' involving her left medial conjunctiva. Orbital CT showed a subcentimeter left preseptal soft tissue density. Biopsy revealed a dense subepithelial lymphoid infiltrate comprised predominantly of B cells that did not coexpress CD5 or CD43. These findings were consistent with B-cell marginal zone lymphoma. Further staging assessment did not reveal disseminated disease. She had stage 1E extranodal marginal zone lymphoma as per Ann Arbor staging system. She received external beam radiotherapy to her left eye with complete resolution of the lymphoma in 2 months and continues to remain tumour free at 8-month follow-up. She will be followed up closely for development of any local (unilateral or contralateral eye) or systemic recurrence in the long run. Copyright 2014 BMJ Publishing Group. All rights reserved.