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Wang, Chung, and Choi: A Case of Conjunctival Hemorrhagic Lymphangiectasia
Case Report
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(9): 1330-1333.

Published online: 17 September 2012

DOI: https://doi.org/10.3341/jkos.2012.53.9.1330

A Case of Conjunctival Hemorrhagic Lymphangiectasia

Dong Hyun Wang, MD, Jin Kwon Chung, MD, Kyung Seek Choi, MD

Department of Ophthalmology, Soonchunhyang University College of Medicine, Seoul, Korea.

Address reprint requests to Jin Kwon Chung, MD. Department of Ophthalmology, Soonchunhyang University Hospital, #22 Daesagwan-gil, Yongsan-gu, Seoul 140-743, Korea. Tel: 82-2-709-9354, Fax: 82-2-710-3196, schcornea@schmc.ac.kr

Received 19 September 2011       Accepted 19 June 2012

Copyright © 2012 The Korean Ophthalmological Society

Abstract

Purpose

To report a case of hemorrhagic lymphangiectasia treated with surgical excision and confirmed by pathologic examination.

Case summary

A 21-year-old man presented with spontaneous hyperemia of his right eye of 1 week duration. The patient had a history of tuberculous retinal vasculitis and uveitis 1 year prior, but there was no active lesion during regular follow-up. There was no history of trauma, visual disturbance, diplopia, ocular pain, or any sign of systemic disease. Slit lamp examination showed tortuous dilatation of blood-filled lymphatic vessels on temporal conjunctiva of the right eye. The lesion did not change during the 4 weeks of follow-up and local excision biopsy was made for final diagnosis and treatment. Pathologic examinations revealed thin-walled lymphatic vessels with localized dilatation which contained blood in the lumen consistent with hemorrhagic lymphangiectasia. There was no sign of recurrence until 2 months after the operation.

Conclusions

Hemorrhagic lymphangiectasia should be considered in patients with recurrent or longstanding localized tortuous subconjunctival hemorrhage.

Keywords: Conjunctiva, Hemorrhage, Hemorrhagic lymphangiectasia, Lymphatic vessel

Figures and Tables

Figure 1
Slit lamp photograph shows tortuous dilatation of conjunctival lymphatic vessels which are segmentally filled with blood, with accompanying subconjunctival hemorrhage.
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Figure 2
Postoperative slit lamp photographs. (A) Conjunctiva with dilated hemorrhagic lymphatics was excised and the defect was covered with 6.0 × 6.0 mm sized conjunctival autograft. (B) Photograph two months after treatment shows little conjunctival scar but no lymphatic dilatation or subconjunctival hemorrhage.
jkos-53-1330-g002
Figure 3
Hemorrhagic lymphangiectasia. (A) Pathologic examination after conjunctival excisional biopsy shows localized dilatation of lymphatic vessels (arrow) (hematoxylin-eosin, ×40). (B) The dilated lymphatics have thin vessel wall and contain blood in the lumen (hematoxylin-eosin, ×200).
jkos-53-1330-g003

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