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[Management of lymphoid hyperplasia of the ocular adnexa].

OBJECTIVE
Lymphoid Hyperplasia (LH) is a benign proliferative lymphocyte-rich process. Histologically, LH may be similar to a lymphoma. Its incidence has decreased because of new sophisticated diagnostic procedures and a better knowledge of lymphomas. Most of the cases are seen in patients between forty and sixty years of age. As there was no consensus about the best treatment, determining this was the objective of our study.


METHOD
We describe three patients with a lymphoproliferative process affecting the ocular anexae, in whom histologic, immuno-histochemical and molecular studies were performed. PCR analysis allowed a definitive diagnosis to be made.


RESULTS
Histologically, all three cases were diagnosed as LH; immuno-histochemically, one was diagnosed as an idiopathic orbital inflammation, and the other two, as LH. After PCR analysis, one of these latter two cases was definitively diagnosed as B-cell Non-Hodgkin's lymphoma.


CONCLUSIONS
Today's molecular techniques allow us to make a definite diagnosis of lymphoma, because sometimes histology and immuno-histochemistry alone can result in a wrong diagnosis being made. LH of the ocular adnexae may be the first stage of a much more serious disease, and a benign hyperplasia at this site must lead to suspicion of lymphoma, which can then be diagnosed or excluded by the improved diagnostic procedures. Therefore, when we make a diagnosis of LH it is necessary to complete a full evaluation and institute a defined follow-up of the patient's clinical condition.