A Case of Conjunctival Mass with Infectious Mononucleosis by EBV

Kyoung Yoon Shin; Moo Hwan Chang; Sung Eun Kyung

doi:10.3341/jkos.2014.55.10.1554

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Shin, Chang, and Kyung: A Case of Conjunctival Mass with Infectious Mononucleosis by EBV

Case Report

J Korean Ophthalmol Soc 2014;55(10):1554-1557.

Published online: 2 September 2014

DOI: https://doi.org/10.3341/jkos.2014.55.10.1554

A Case of Conjunctival Mass with Infectious Mononucleosis by EBV

Kyoung Yoon Shin, MD, Moo Hwan Chang, MD, PhD, Sung Eun Kyung, MD, PhD

Department of Ophthalmology, Dankook University Medical College, Cheonan, Korea

Address reprint requests to Sung Eun Kyung, MD, PhD, Department of Ophthalmology, Dankook University Hospital, #201 Manghyang-ro, Dongnam-gu, Cheonan 330-715, Korea, Tel: 82-41-550-6497, Fax: 82-41-561-0137 E-mail: kseeye@hanmail.net

Received 7 February 2014 Revised 9 July 2014 Accepted 17 September 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report a case of conjunctival mass with infectious mononucleosis by Epstein-Barr virus (EBV) confirmed with Epstein-Barr encoding region (EBER) in situ hybridization.

Case summary

A 8 year-old male without underlying disease was referred with counjunctival mass on the right eye starting 3 days ago. In ophthalmologic evaluation, there was injected, nontender, and “salmon patch” appearance conjunctival lesion on right superior bulbar conjunctiva. The patient was admitted to pediatrics with sore throat and fever. The tonsil were enlarged and white blood cell count was 14960/uL. EBV polymerase chain reaction (PCR) test and Viral capsid antigen Immunoglobulin M (VAC IgM) test were positive, the diagnose of infectious mononucleosis by EBV was made. After 5 days steroid eyedrop therapy, biopsy was performed because the lesion was not improved. There were lymphocyte infiltration, chronic inflammation and positive in EBER in situ hybridization.

Conclusions

Elevated and pinkish lesion on conjunctiva, EBV lesion should be considered as differential diagnosis.

Keywords: Conjunctival mass, Infectious mononucleosis

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Figure 1.

(A, B) The slit lamp examination showed “Salmon patch” lesion on suprabulbar conjunctiva of the right eye at the first visit. (C) At 2 months later, suprabulbar injected lesion was improved, (D) at 6 months later, suprabulbar lesion returned to normal.

Figure 2.

Serum Epstein-Barr virus (EBV) polymerase chain reaction (PCR). (A) Patient, (B) positive sample. (C) Negative sample.

Figure 3.

(A) Microscopically, the biopsy specimen of conjunctival mass reveals a dense lymphoplasm a cell infiltrate in lamina propria as well as into epithelium (hematoxylin-eosin stain, original magnification ×400). (B) Epstein-Barr virus is detected in some lymphocytes by Epstein-Barr encoding region (EBER) in situ hybridization (in situ hybridization, original magnification ×400).

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