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Bilateral benign reactive lymphoid hyperplasia of the conjunctiva treated with oral doxycycline

Poster Details

First Author: G.Kondylis GREECE

Co Author(s):    O. Klavdianou   V. Georgopoulos   S. Palioura              

Abstract Details


To report a case of bilateral benign reactive lymphoid hyperplasia (BRLH) of the conjunctiva treated with oral doxycycline and to review the presentation, treatment and risk of transformation to lymphoma of all cases published to date.


Tertiary referral center


A 30-year-old man presented for evaluation of an enlarging lesion in the right eye. Upon slit lamp examination a nasal pterygium was observed in the right eye and fleshy pink medial canthal conjunctival lesions were seen in both eyes. Incisional biopsy of the medial canthal lesions revealed BRLH. Oral doxycycline was initiated (100 mg two times a day) for a total of two months.


Both lesions became significantly smaller after 2 moths. The lesion in the right eye was excised along with the nasal pterygium and the patient has been free of recurrence for the past 1.5 years. The lesion in the left eye has remained stable in size after cessation of the oral doxycycline. Literature review of 235 reported cases of conjunctival BRLH revealed that lesions were bilateral in 26.6% of patients. Common treatments were surgical excision (70%) followed by observation (13%) and corticosteroid use (11%). Recurrence occurred in five patients (2.1%). One patient (0.4%) developed conjunctival lymphoma and one (0.4%) systemic lymphoma.


Oral doxycycline can be used as an alternative non-invasive treatment of BRLH conjunctival lesions. Literature review reinforces the notion that patients with BRLH lesions warrant careful follow up as such lesions can rarely transform into conjunctival or systemic lymphoma.

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