Isolated Langerhans Cell Histiocytosis in the Palpebral Conjunctiva of an Adult Patient

ABSTRACT

PURPOSE: To report a case of isolated Langerhans cell histiocytosis (LCH) in the palpebral conjunctiva of an adult patient. METHODS: A 39-year-old male presented with a mass of one month's duration on the palpebral conjunctiva of his left upper lid. The lesion had gradually progressed. The mass was non-tender, relatively well circumscribed, yellowish white, flat, firm, and 5 mm x 8 mm in size. Otherwise, the ophthalmic examination was completely normal, including the anterior and posterior segments. Based on the clinical picture, an infiltrative/neoplastic lesion was suspected. Incision biopsy was performed to obtain a diagnosis for proper management. RESULTS: The histopathologic examination of the lesion showed an intensive proliferation of monotonous and histiocytoid cells beneath the epidermis. Immunohistochemical study revealed that the tumor cells were positively stained in the cytoplasm with anti CD1A antibody and anti S-100 antibody. The patient was then referred to the Oncology Department for evaluation. A detailed systemic examination, and the laboratory and radiologic investigations ruled out systemic involvement. The diagnosis of isolated LCH was finally made. Three months later, the lesion underwent remission without any treatment. CONCLUSIONS: This rare disorder may also present as a solitary lesion on the palpebral conjunctiva in adults, and so it should be kept in mind during the differential diagnosis of a conjunctival mass in an adult.