Case report reveals conjunctival atypical lymphoid hyperplasia positive for cytomegalovirus in an adult male, highlighting the need to evaluate chronic ocular lesions for viral drivers.
PURPOSE: We report a rare case of CMV-associated conjunctival atypical lymphoid hyperplasia (ALH). METHODS: A case report. RESULTS: A 34-year-old Chinese male with a 2-year history of recurrent bilateral redness, photophobia, and tearing, and no systemic or prior ocular illnesses, presented with severe bilateral conjunctival hyperemia, gelatinous limbal hyperplasia, and corneal opacities. Surgical excision was performed. Histopathology and immunohistochemistry revealed atypical lymphoid hyperplasia with a clonal B-cell population and CMV positivity within the lesional tissue. CONCLUSION: This case expands the clinical spectrum of ocular CMV disease and underscores the importance of considering CMV in the differential diagnosis of chronic, atypical conjunctival lesions. The relationship between CMV infection and ALH warrants further investigation. Long-term follow-up is needed to monitor for local recurrence or progression to overt lymphoma.
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