Concurrent chronic follicular conjunctivitis and conjunctival MALT lymphoma potentially caused by Chlamydia pneumoniae

Chlamydia, particularly C. psittaci, has been implicated in the pathogenesis of ocular adnexal lymphoma with varying geographical prevalence. We report a patient with concurrent chronic follicular conjunctivitis and conjunctiva mucosa-associated lymphoid tissue (MALT) lymphoma, potentially caused by...

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Main Authors: Yueh-Ling Chen, Shih-Ming Jung, Ching-Hsi Hsiao
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:IDCases
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Online Access:http://www.sciencedirect.com/science/article/pii/S2214250925001076
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author Yueh-Ling Chen
Shih-Ming Jung
Ching-Hsi Hsiao
author_facet Yueh-Ling Chen
Shih-Ming Jung
Ching-Hsi Hsiao
author_sort Yueh-Ling Chen
collection DOAJ
description Chlamydia, particularly C. psittaci, has been implicated in the pathogenesis of ocular adnexal lymphoma with varying geographical prevalence. We report a patient with concurrent chronic follicular conjunctivitis and conjunctiva mucosa-associated lymphoid tissue (MALT) lymphoma, potentially caused by C. pneumoniae. A 30-year-old female presented with a 10-month history of persistent discharge from the left eye. Examination of the conjunctiva revealed large follicles and a salmon-patched lesion over inferior fornix. Chlamydial antigen testing from conjunctival swab was positive, so the patient underwent a 3-week course of oral doxycycline (100 mg, twice daily), after which the discharge resolved, but the conjunctival mass persisted. A subsequent conjunctival biopsy identified extranodal marginal zone lymphoma of MALT type. Following systemic evaluations, clinical staging indicated T1N0M0, stage IE. The patient received a total 3060 cGy of radiotherapy in 17 fractions, leading to regression of the lesion. Touchdown Enzyme Time-Release polymerase chain reaction analysis of formalin-fixed paraffin-embedded biopsy samples confirmed the presence of C. pneumoniae DNA. This case highlights a potential association between chronic follicular conjunctivitis and conjunctival MALT lymphoma, possibly linked to C. pneumoniae infection. The potential causality warrants further investigation.
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spelling doaj-art-e4f213c7430e4020b5a34491cc706f6b2025-08-20T03:45:44ZengElsevierIDCases2214-25092025-01-0140e0225110.1016/j.idcr.2025.e02251Concurrent chronic follicular conjunctivitis and conjunctival MALT lymphoma potentially caused by Chlamydia pneumoniaeYueh-Ling Chen0Shih-Ming Jung1Ching-Hsi Hsiao2Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, TaiwanDepartment of Pathology, Chang Gung Memorial Hospital, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, TaiwanDepartment of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Correspondence to: Department of Ophthalmology, Chang Gung Memorial Hospital, No. 5, Fu-Hsing St, Kuei Shan, Taoyuan 333, Taiwan.Chlamydia, particularly C. psittaci, has been implicated in the pathogenesis of ocular adnexal lymphoma with varying geographical prevalence. We report a patient with concurrent chronic follicular conjunctivitis and conjunctiva mucosa-associated lymphoid tissue (MALT) lymphoma, potentially caused by C. pneumoniae. A 30-year-old female presented with a 10-month history of persistent discharge from the left eye. Examination of the conjunctiva revealed large follicles and a salmon-patched lesion over inferior fornix. Chlamydial antigen testing from conjunctival swab was positive, so the patient underwent a 3-week course of oral doxycycline (100 mg, twice daily), after which the discharge resolved, but the conjunctival mass persisted. A subsequent conjunctival biopsy identified extranodal marginal zone lymphoma of MALT type. Following systemic evaluations, clinical staging indicated T1N0M0, stage IE. The patient received a total 3060 cGy of radiotherapy in 17 fractions, leading to regression of the lesion. Touchdown Enzyme Time-Release polymerase chain reaction analysis of formalin-fixed paraffin-embedded biopsy samples confirmed the presence of C. pneumoniae DNA. This case highlights a potential association between chronic follicular conjunctivitis and conjunctival MALT lymphoma, possibly linked to C. pneumoniae infection. The potential causality warrants further investigation.http://www.sciencedirect.com/science/article/pii/S2214250925001076ChlamydiaFollicular conjunctivitisMucosa-associated lymphoid tissue (MALT) lymphoma
spellingShingle Yueh-Ling Chen
Shih-Ming Jung
Ching-Hsi Hsiao
Concurrent chronic follicular conjunctivitis and conjunctival MALT lymphoma potentially caused by Chlamydia pneumoniae
IDCases
Chlamydia
Follicular conjunctivitis
Mucosa-associated lymphoid tissue (MALT) lymphoma
title Concurrent chronic follicular conjunctivitis and conjunctival MALT lymphoma potentially caused by Chlamydia pneumoniae
title_full Concurrent chronic follicular conjunctivitis and conjunctival MALT lymphoma potentially caused by Chlamydia pneumoniae
title_fullStr Concurrent chronic follicular conjunctivitis and conjunctival MALT lymphoma potentially caused by Chlamydia pneumoniae
title_full_unstemmed Concurrent chronic follicular conjunctivitis and conjunctival MALT lymphoma potentially caused by Chlamydia pneumoniae
title_short Concurrent chronic follicular conjunctivitis and conjunctival MALT lymphoma potentially caused by Chlamydia pneumoniae
title_sort concurrent chronic follicular conjunctivitis and conjunctival malt lymphoma potentially caused by chlamydia pneumoniae
topic Chlamydia
Follicular conjunctivitis
Mucosa-associated lymphoid tissue (MALT) lymphoma
url http://www.sciencedirect.com/science/article/pii/S2214250925001076
work_keys_str_mv AT yuehlingchen concurrentchronicfollicularconjunctivitisandconjunctivalmaltlymphomapotentiallycausedbychlamydiapneumoniae
AT shihmingjung concurrentchronicfollicularconjunctivitisandconjunctivalmaltlymphomapotentiallycausedbychlamydiapneumoniae
AT chinghsihsiao concurrentchronicfollicularconjunctivitisandconjunctivalmaltlymphomapotentiallycausedbychlamydiapneumoniae