流涙を主訴とした悪性リンパ腫の2例

Two cases of conjunctival malignant lymphoma with lacrimation as chief complaint

　流涙を主訴として受診し，結膜悪性リンパ腫と診断された2症例。症例と所見：1例は77歳女性。15年前から両眼に流涙があり放置していた。両眼の下結膜円蓋部に腫瘤があり，病理組織検査でMALT型非ホジキン悪性リンパ腫と診断した。放射線照射で腫瘍は消失した。他の1例は57歳男性。咽頭のびまん性大細胞型B細胞悪性リンパ腫の治療中に右眼に流涙が生じた。右球結膜に腫瘤があり，病理組織検査でびまん性B細胞悪性リンパ腫と診断し，咽頭腫瘍からの転移が疑われた。化学療法で咽頭腫瘍は縮小しつつある。結論：流涙を主訴とした症例では結膜の悪性リンパ腫の可能性があり，特に円蓋部の検索が必要である。

Purpose: To describe two cases of conjunctival malignant lymphoma with lacrimation as the ini-tial ocular manifestation. Cases and Findings: A 77-year-old female presented with lacrimation in both eyes since 15 years before. A tumor was detected in the lower fornix in both eyes. Histopathological studies led to the diagnosis of MALT type of non-Hodgkin lymphoma. The tumor disappeared following radiation. An-other 57-year-old male developed lacrimation in his right eye during treatment for pharyngeal malignant lym-phoma. A tumor was present in the bulbar conjunctiva in the affected eye. It was diagnosed with diffuse B cell malignant lymphoma, probably metastatic from the pharynx. Systemic chemotherapy induced regression of pharyngeal tumor. Conclusion: Lacrimation may be the initial manifestation of malignant lymphoma of the conjunctiva, particularly in the fornix. Due attention is advocated in cases of lacrimation with this possibility in mind.