결막 반달주름에 발생한 단일 결막 황색종
Solitary Conjunctival Xanthoma at the Plica Semilunaris
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목적: 결막의 반달주름에서 발생한 단일 결막 황색종을 최초 보고하고자 한다. 증례요약: 특이 과거력 없는 39세 여자 환자가 최근 우연히 발견한 우안의 무통성의 코 쪽 결막 부종을 주소로 내원하였다. 우안 세극등현미경상 황색이고 내부가 비교적 반투명하였으며 결막에 잘 덮여 있는 유동성인 타원형 종괴가 결막 반달주름의 귀 쪽 부위에서 관찰되었다. 수직 길이는 약 8 mm이고 귀 쪽 경계는 비교적 명확하였나, 코 쪽 경계는 눈물언덕 뒤에 가려 불확실하였다. 반응성 림프양 증식증을 염두에 두고 1주간 국소 및 전신 스테로이드를 투여하고 독시사이클린을 복용하였으나 호전을 보이지 않아 시행한 절제 생검상 황색종으로 진단되었다. 혈액검사상 이상지질혈증은 관찰되지 않았다. 결론: 결막 황색종은 기존 보고된 바 이외에도 결막의 반달주름에서 발생할 수 있으며, 형태학적으로는 안와 지방, 림프증식질환을 포함한 타 질환들과 감별하기 어렵기 때문에 신속한 절제 생검이 진단에 도움이 될 수 있겠다.
Abstract
Purpose: To report a case of conjunctival xanthoma occurring at the plica semilunaris. Case summary: A 39-year-old female with no specific medical history visited our hospital due to a recent incidental detection ofa painless mass in the nasal conjunctiva of her right eye. Slit-lamp bio-microscopic examination revealed a yellowish movableoval mass with inner semi-translucency in the temporal area of the plica semilunaris. The vertical length of the mass was approximately8 mm. It was well-demarcated at its temporal border; however, the nasal border was obscured behind the plicasemilunaris. Considering a possible conjunctival reactive lymphoid hyperplasia, topical and systemic steroids as well as oraldoxycycline were administrated for 1 week; however, the lesion showed no improvement. An excisional biopsy was performed;pathological diagnosis indicated conjunctival xanthoma. The patient’s blood lipid profile was within the normal range. Conclusion: Conjunctival xanthoma can develop near the plica semilunaris. Because it is difficult to distinguish xanthoma fromother diseases including orbital fat prolapse or lymphoproliferative disease, rapid biopsy would be helpful for an early diagnosis.
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