gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

Bilateral conjunctival tumors as primary manifestation of sarcoidosis

Meeting Abstract

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  • corresponding author G. Schilgen - Department of Ophthalmology, Heinrich-Heine University, Düsseldorf
  • A. Böcking - Institute of Cytopathology, Heinrich-Heine University, Düsseldorf
  • R. Sundmacher - Department of Ophthalmology, Heinrich-Heine University, Düsseldorf

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogP 008

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Veröffentlicht: 22. September 2004

© 2004 Schilgen et al.
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Next to the common pulmonal manifestation of sarcoidosis an additional or exclusive extrapulmonal manifestation is described. Ocular manifestation of sarcoidosis varies enormously. It includes the conjunctiva, lacrimal gland, orbita, intraocular structures and eye lid, either isolated or combined. We describe a female patient, who presented with unusually massive, bilateral conjunctival tumors as a primary manifestation of sarcoidosis.


A 79-year-old white woman was referred to us for further management of a persisting "conjunctivitis", which had been refractory to treatment with multiple medications for 4 months.


Her medical history was negative for any known diseases. Initial examination disclosed swollen eye-lids and bilateral large hard tumors of the inferior fornix. The obtained brush smear, which was cytopathologically evaluated, revealed epitheloid cells and multinucleate giant cells. The following biopsy from the inferior fornix showed a granulomatous epitheloid cell inflammation without central necrosis typical for sarcoidosis. After 4 weeks she developed three reddish-brown maculopapular lesions on her face. The histopathological examination of a skin biopsy showed the same features as the conjunctival tumors. At this time the systemic evaluation for presumed sarcoidosis revailed no other manifestation.


An isolated bilateral primary manifestation of sarcoidosis by massive conjunctival tumors is very rare and thus clinically not typical. Nevertheless it has to be considered in the differential diagnosis of tumors of the conjunctiva (especially lymphoma) and chronic, proliferative conjunctivitis. The non-invasive, cytopathological examination by means of brush smears offers a new perspective in the fast diagnosis of conjunctival manifestation of sarcoidosis.