Journal List > J Korean Ophthalmol Soc > v.53(9) > 1009174

Wang, Chung, and Choi: A Case of Conjunctival Hemorrhagic Lymphangiectasia

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.

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.
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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).
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