재발 결막낭종처럼 보이는 단독 결막림프관종 1예

A Case of Isolated Conjunctival Lymphangioma Mimicking a Recurrent Conjunctival Cyst

목적: 재발 결막낭종에서 단독 결막림프관종으로 진단된 1예를 보고하고자 한다. 증례요약: 39세 남자가 1개월 전부터 발생한 우안 결막낭종을 주소로 내원하였다. 1주일 전 타 의료기관에서 결막낭종흡인술을 시행하였으나 이후 재발하여 본원에 의뢰되었다. 초진 시 세극등현미경에서 결막낭종 내 황색의 혼탁한 액체와 출혈 소견이 함께 관찰되었고, 안저검사에서는 특이 소견이 발견되지 않았다. 우선적으로 점안 항생제와 스테로이드 치료를 시행하였다. 3주 후 출혈 소견은 흡수되었으나 낭종 크기의 변화가 없어, 수술적 낭종제거술과 조직검사를 시행하였다. 조직검사에서 CD 31 양성과 D2-40 양성 소견을 보여 낭성 결막림프관종으로 진단되었다. 이후 림프관종에 동반될 수 있는 안와 림프관종 및 전신질환 확인을 위해 brain MRI를 시행하였으며 특이 소견은 없었다. 수술 후 1년 6개월째 결막낭종의 재발은 없었으며 다른 안과적 또는 전신적 합병증은 관찰되지 않았다. 결론: 단독 결막림프관종은 드물며, 림프관종의 진단에서 안와 림프관종 등 동반 질환의 확인을 위한 전신검사의 시행이 필요하다.

Purpose: To report a case of isolated conjunctival lymphangioma mimicking a recurrent conjunctival cyst. Case summary: A 39-year-old male with a conjunctival cyst in the right eye lasted for 1 month visited our hospital. He had pre-viously undergone aspiration of the cyst at another hospital 1 week before visiting our hospital. However, the cyst recurred, and he was referred to our hospital. On slit lamp biomicroscopy, yellow-colored turbid fluid and a hemorrhage were observed in the conjunctival cyst, but no specific finding was found in the fundus photography. The patient was initially treated with topical anti-biotics and steroids. Three weeks later, absorption of the hemorrhage was noted, but there was no change in the size of the cyst. Therefore, surgical removal and histological examination of the cyst were performed. The histological examination revealed that the lesion was positive for CD 31 and D2-40, and the cyst was diagnosed as a cystic conjunctival lymphangioma. Thereafter, brain magnetic resonance imaging was performed to screen for orbital lymphangioma and systemic disease that could accompany a conjunctival lymphangioma. However, no specific findings were observed. There was no recurrence of the conjunctival cyst at 1 year and 6 months after surgical removal, and no other ophthalmic or systemic complication was observed. Conclusions: An isolated conjunctival lymphangioma is a rare lesion. In the diagnosis of lymphangioma, systemic examination is recommended for the identification of comorbid diseases, such as orbital lymphangioma.