Burkitt lymphoma presenting as a conjunctival mass.

PURPOSE: A sporadic Burkitt lymphoma, which presented as a primary conjunctival mass, demonstrates the approach to clinical diagnosis, staging, and current management of this rapidly growing malignant tumor, as well as newer concepts of its pathogenesis. PATIENT AND METHODS: A 16-year-old girl had rapid development of a conjunctival mass 6 weeks after an infectious mononucleosis-like illness, associated with a positive monospot test. A biopsy of the tumor was immunostained for lymphocyte markers. Additional clinical workup included computed tomographic scanning, nasopharyngeal biopsy, and studies of blood, bone marrow, and spinal fluid. In situ hybridization for Epstein-Barr virus (EBV)-encoded nuclear RNA was performed on the tumor and adenoidal tissue. RESULTS: The conjunctival biopsy showed a typical Burkitt lymphoma with markers positive for predominantly B lymphocytes. Computed tomographic scans indicated residual tumor in the anterior orbit. Biopsy of thickened adenoidal tissue showed only benign lymphoid hyperplasia. Evidence of EBV infection was found in the adenoidal tissue but not in the tumor cells. The patient was treated with combined chemotherapy on a Pediatric Oncology Group Study protocol for localized non-Hodgkin lymphoma, and is disease-free 4 1/2 years after diagnosis. CONCLUSIONS: A sporadic Burkitt lymphoma arising in the conjunctiva appears to be the first reported in this site. The lymphoma responded well to chemotherapy, which is now the usual course in stage 1 disease. A direct role for EBV in the oncogenesis of this sporadic tumor, similar to that in the endemic form, could not be supported because EBV-encoded nuclear RNA was absent in the tumor cells.

Radiation therapy in amyloidosis of the eyelid and conjunctiva: a case report.

Many questions about amyloidosis are still unanswered. Etiology and pathogenesis remain unclear. Diagnosis is difficult to prove without a biopsy. Several approaches have been tried, but no effective cure has been documented. Russian authors report the use of cobalt therapy for a patient with local laryngeal amyloidosis. This paper presents a case report of a patient with local amyloidosis of the conjunctiva. Superficial radiation therapy was used, and resulted in some shrinkage of the lesions. Surgical excision was later utilized to remove the remaining amyloid deposits.

Pediatric nasolacrimal pigtail probes.

This paper describes two nasolacrimal probes designed for pediatric use. Patterned after the Beyer probe, the first has a diameter that is smaller by 25%. The second has the smaller diameter and also a curvature radius that has been reduced by 25%. Other features of the instruments are unchanged. These probes seem safer and easier to use with pediatric patients.

Ionizing radiation from tinted single vision spectacle lenses.

Some ophthalmic lenses are tinted using materials which contain trace amounts of thorium or daughter products of the thorium and uranium chains. Such lenses emit small amounts of ionizing radiation. No tissue damage has been proven as a result of wearing these eyeglasses. Still, any radiation exposure is a potential hazard. Since there are many essentially nonradioactive lenses on the market, tinted lenses containing thorium contaminants would seem to represent an unnecessary risk.

Ibuprofen in the treatment of central serous chorioretinopathy.

A search of the literature yielded only one other paper concerning the use of ibuprofen for ophthalmic purposes. Marsili and Conte 8 used ibuprofen on a total of 138 patients with a variety of problems, both surgical and nonsurgical. They found an excellent to good response in about three fourths of their patients. This series of patients did as well or better. Three of the 4 were significantly helped with ibuprofen, and were pleased with the results. The fourth patient quite obviously did better while taking ibuprofen than she did without medication, and her visual acuity remained about the same as during steroid therapy. However, the patient herself was not satisfied with the results. It is my conclusion that ibuprofen has merit in the treatment of central serous chorioretinopathy. The concerned ophthalmologist may find the use of ibuprofen preferable to steroids in view of the dangers when these drugs are used at high dosages or for prolonged periods.

A simplified method of nasolacrimal irrigation.

A simplified method of nasolacrimal irrigation is presented. Use of the air cannula minimizes possible edema and trauma because it usually eliminates the need for dilation. In addition, its smaller diameter reduces the possibility of injury during the actual irrigation.