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Conjunctival Pseudotumor Caused by Herpes Simplex Virus Infection

Gargi Khare Vora, MD1; Brian Marr, MD2; Thomas J. Cummings, MD3; Prithvi Mruthyunjaya, MD4
[+] Author Affiliations
1Department of Cornea and Refractive Surgery, Duke Eye Center, Durham, North Carolina
2Department of Ophthalmic Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
3Department of Pathology, Duke Eye Center, Durham, North Carolina
4Department of Vitreoretinal Surgery and Ocular Oncology, Duke Eye Center, Durham, North Carolina
JAMA Ophthalmol. 2015;133(1):105-107. doi:10.1001/jamaophthalmol.2014.3316.
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A conjunctival mass in a patient with human immunodeficiency virus (HIV) can have a long differential diagnosis, ranging from opportunistic infections to malignant neoplasms. Given that patients in this population may have atypical presentations, the benefit of invasive biopsy often outweighs surgical risk and can help guide treatment. We report 2 cases of patients referred to our ocular oncology services with herpetic conjunctivitis that masqueraded as conjunctival tumors.

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Figure 2.
Case 2

A, Appearance of the conjunctival lesion on presentation. B, Hematoxylin-eosin staining of the biopsy specimen showing viral cytopathic features such as multinucleated giant cells and nuclear inclusions (original magnification ×10). C, Resolution of the lesion 1.5 years after presentation.

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Figure 1.
Case 1

A, Appearance of the conjunctival mass on presentation. B, Hematoxylin-eosin staining of the mass showing multinucleated giant cells and plasma cell infiltrate (original magnification ×20). C, Positive immunostaining for herpes simplex virus antigen in areas of multinucleated giant cells (original magnification ×20). D, Appearance of the eye 1 month after lesion excision.

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