Peripheral T-cell lymphoma with bilateral ocular involvement

Although most lymphoma subtypes have been reported in the eye,[1] the vast majority of ocular lymphomas are non-Hodgkin lymphomas (NHLs) of B-cell type; a small minority (1%–2%) are derived from T-lymphocytes or natural killer cells.[1] Here, we report a rare case of conjunctival peripheral T-cell lymphoma not otherwise specified (PTCL NOS) in a 47-year-old female. Slit-lamp examination showed salmon-colored limbal thickening of the conjunctiva, characteristic of conjunctival lymphoma. This was associated with bone marrow and lymph node involvement. The lymphoma was treated with six cycles of cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) chemotherapy, followed by consolidation with autologous hematopoietic stem cell transplantation, resulting in durable complete systemic and conjunctival remission at 6 months of follow-up. Conjunctival T-cell lymphoma can present with minimal and nonspecific symptoms, making it imperative for the clinician to consider ocular lymphoma when presented with unexplained conjunctivitis.