J Korean Ophthalmol Soc.  2011 May;52(5):628-632. 10.3341/jkos.2011.52.5.628.

A Case of Bilateral Conjunctival Amyloidosis Treated with Mass Excision and Cryotherapy

• Kim B
• Song JH
• Yang SW
• Kim MS

• KMID: 2214585
• DOI: http://doi.org/10.3341/jkos.2011.52.5.628

Abstract

PURPOSE
To report the treatment results of mass excision and cryotherapy in a case of bilateral conjunctival amyloidosis.
CASE SUMMARY
A 72-year-old man with conjunctival mass and foreign body sensations in both eyes visited our clinic. He was previously diagnosed with conjunctival lymphoma after conjunctival biopsy at another hospital. A yellow-pink colored mass was observed in the bulbar conjunctiva. A repeated conjunctival biopsy revealed the mass to be amyloid, consistent with the cervical lymph node biopsy results, and the diagnosis was changed to primary systemic amyloidosis. The patient was treated with melphalan and prednisolone; however, the ocular pain, symblepharon, and conjunctival mass progressed. A 360 degree conjunctivoperiotomy, mass excision, and repeated cryotherapy were performed in the more severely affected left eye. The patient was followed for one year, and there were no complications or progression of the conjunctival lesion.
CONCLUSIONS
Conjunctival amyloidosis requires local pathologic confirmation as well as a systemic work-up. If surgical removal is necessary despite systemic treatment, mass excision and cryotherapy may be effective.

Keyword

Congo-red; Conjunctival amyloidosis; Cryotherapy

MeSH Terms

Aged
Amyloid
Amyloidosis
Biopsy
Conjunctiva
Cryotherapy
Eye
Foreign Bodies
Humans
Lymph Nodes
Lymphoma
Melphalan
Sensation
Amyloid
Melphalan

Figure

• 

  Figure 1. A 4×3 mm sized yellow mass (A) (arrow) is seen in the inferomedial conjunctiva in the right eye. A 6×5 mm sized yel-low-pinkish mass (B) (arrow) is seen in the inferomedial conjunctiva in the left eye. The mass was larger and more severe in the left eye.

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  Figure 2. Depositions of amorphous, homogenous eosinophilic material (arrow) are seen in the conjunctiva. The black arrow indicates eosinophilic material (A) (H&E staining, ×100). Dichroism and birefringence are seen (B) (Congo-red staining, polarizing filter, ×400).

• 

  Figure 3. External findings of left eye before mass excision (A) and after treatment with cryotherapy and mass excision (B).

Reference

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