Year : 1967 | Volume
: 15 | Issue : 1 | Page : 38--39
Solitary plasmocytoma of conjunctiva
S Bhargava, MC Gupta, K Vyas, BP Saxena
Department of Pathology, G. R. Medical College, Gwalior, India
Department of Pathology, G. R. Medical College, Gwalior
|How to cite this article:|
Bhargava S, Gupta M C, Vyas K, Saxena B P. Solitary plasmocytoma of conjunctiva.Indian J Ophthalmol 1967;15:38-39
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Bhargava S, Gupta M C, Vyas K, Saxena B P. Solitary plasmocytoma of conjunctiva. Indian J Ophthalmol [serial online] 1967 [cited 2023 Jun 1 ];15:38-39
Available from: https://journals.lww.com/ijo/pages/default.aspx/text.asp?1967/15/1/38/38679
Extramedullary plasma cell tumours are rare and those involving the con�junctivae still so. Pascheff (1908) first described plasma cell tumour of con�junctivx under the heading of `Plas�moma' of conjunctiva. Since then to the best of our knowledge only 50 cases of plasmocytoma of the conjunc�tiva have been reported in world lite�rature. Hellwig (1943) reviewed 29 of them.
The following case report of a case of plasmocytoma of the conjunctiva who came under our observation is be�ing presented for its rarity and a re�minder that though rare, the conjunc�tival plasmocytoma is not an extinct entity.
M.D., female aged 30 years came to the outpatients department with the complaints of foreign body sensation and redness of right eye. The dura�tion of symptoms was one year. On examination there was a greyish white nodule about 2 mm. in diameter on the upper palpebral conjunctiva nearer to the medial canthus of the eye. The growth was sessile and its surface smooth. There was no infiltra�tion into the surrounding tissues and the growth could be excised complete�ly without much difficulty. The clini�cal diagnosis was "Papilloma". Un�fortunately the growth was excised in the operation theatre of minor surgery in O.P.D. and no laboratory investi�gations were done on the patient prior to excision. Eventually, despite best efforts to contact the patient for a de�tailed pathological and radiological examination the patient could not be brought for these investigations,
Histopathological examination of the tumour tissue showed sheets of plasma cells with hardly any stroma in between them. The cells were round or oval, with eccentric nucleus. The chromatin of the nucleus was arrang�ed in typical cartwheel manner. There were no giant cells.
The following views are put for�ward regarding the nature of plasmo�cytoma of conjunctivae.
(1) Hyaline degeneration of the stroma of many conjunctival plasma cell tumours, with the formation of true amyloid in a few cases has led to the impres�sion that amyloid and hyaline tumours of conjunctiva are pos�sibly terminal stages of plasmoma.
Pascheff (1908) commented on the similarity between plasmoma and amyloid tumour of eye. Deut�schmann (1912) included plas�moma in well known entities of hyaline and amyloid degenera�tion of conjunctiva. Baurmann (1922) held that plasmoma may lead to hyaline and amyloid de�generation of conjunctiva but it is not the only disease which pre�cedes it.
(2) Same observers assume an aetio�logical relationship between plas�moma and trachoma. While cul�ture and inoculation methods with use of fragments from plasma cell tumours have been most un�successful (Pascheff, 1939, James, 1929), it is a fact that in a large number of cases plasmoma is complicated or preceded by tra�choma. Most cases of plasmoma have been reported from coun�tries where trachoma is endemic.
Botteri and Spanie inoculated pieces of plasmoma into conjunc�tiva of baboon and produced trachoma. According to Kreibig (1933), in only 5 cases of the pub�lished 15 cases of plasmoma, can trachoma be definitely excluded as an aetiological factor. On the other hand, Howard and Saundo�koff were unable to prove any aetiological relationship between trachoma and plasmoma and they mentioned that the association is coincidental. However, the pre�sent knowledge is insufficient to answer the aetiological relation�ship between the two.
Review of Clinical Features
1. Age and sex of the patient: Hell�wig (1943) in his review article has commented on the relatively high incidence of these lesions in females and the occurrence at an early age, as contrast to plasma cell tumours of air passages. He reports the mean age as 37.7 years.
Hellwig's statement regarding age and sex of the patient is quite in favour of our findings.
2. Absence of invasion: Hellwig has further commented that there was no report of invasion of eye itself or of orbital bones in the cases that lie reviewed. This was again confirmed in our case.
3. The microscopic appearance of our tumour resembles the descrip�tion of similar tumours given by Hellwig.
4. The authors are at a loss to re�view critically Hellwig's state�ment that "as to the clinical course, there is general agreement that conjunctival plasma cell tumours are non-cancerous, with very indistinct neoplastic proper�ties. The general condition was never affected and laboratory tests were entirely negative. Ex�cision was the treatment of choice and was often successful", because the case could not be adequately followed up.
|1||Baurmann. H.: (1932). Arch. f. Ophth. 109: 236.|
|2||Botteri and Spanie: Quoted by Hell�wig. 1943.|
|3||Deutschmann, F.: Quoted by Hellwig, 1943.|
|4||Hellwig. C. A,: (1943). Arch. Path. 36: 96.|
|5||Howard and Saundokoff: Quoted by Hellwig, 1943.|
|6||Kreibig. W.: (1933), Arch. f. Ophth. 131: 89.|
|7||Pascheff, C.: (1908). Arch, f. Ophth. 68: 114. 1908.|
|8||Pascheff, C., & James, W. H.: Quoted by Hellwig, 1943.|
|9||Willis. R. A.: Pathology of Tumours, 3rd edition. 1960.|