UVEAL LYMPHOID INFILTRATION - REPORT OF 4 CASES AND CLINICOPATHOLOGICAL REVIEW

Purpose: The purpose of the study was to report the clinicopathologic features of four patients with uveal lymphoid infiltration who were di agnosed by a conjunctival biopsy. Design: A case series. Participants: Four patients at four institutions participated. Measures: The histop athologic findings of the conjunctival and episcleral biopsy specimens from four patients with the diagnosis of uveal lymphoid infiltration were recorded. The conjunctival specimens were placed in 10% neutral b uffered formaldehyde solution or B5 solution and processed routinely f or light microscopic examination and immunohistochemical analysis for B cells and T cells and kappa and lambda light chains. The clinical an d histopathologic findings were compared with 47 previously reported c ases of uveal lymphoid infiltration.Results: Two men and two women (av erage age = 57 years) presented with diffuse punctate to coalescent ye llow uveal infiltrates and epibulbar pink fleshy lesions. Ultrasonogra phy of the lesions showed diffuse choroidal thickening and a lack of c horoidal or scleral excavation. The conjunctival biopsy specimens show ed diffuse infiltration of the substantia propria with B lymphocytes w ith variable kappa and lambda restriction. Scattered T lymphocytes als o were present, Plasmacytoid cells and a prominent Grenz zone were pre sent. Conclusions: Patients with solitary or multiple yellow uveal inf iltrates should have careful conjunctival evaluation for the presence of pink conjunctival lesions. Biopsy specimens of the conjunctival les ion may establish the diagnosis of uveal lymphoid infiltration.