Intraocular juvenile xanthogranuloma masquerading as conjunctivitis in an adult

Abstract

A 22-year-old female presented to us with redness, pain and intermittent blurring of vision in the left eye of one month duration. She had been diagnosed as a case of conjunctivitis elsewhere for which she was being treated with topical antibiotics. Examination of the anterior segment revealed diffuse conjunctival congestion, the presence of an inferonasal iris bulge and a streak of hyphema. Ultrasound biomicroscopy revealed an irregular echogenic mass lesion in the iris extending into the ciliary body. Fine needle aspiration cytology revealed the presence of large giant cells with multiple nuclei and pigments in the cytoplasm suggestive of Touton giant cells and multiple histiocytes confirming the diagnosis of juvenile xanthogranuloma. The patient was prescribed oral and topical steroids and the lesion resolved. Juvenile xanthogranuloma can masquerade as conjunctivitis and simple aspiration cytology can be helpful in establishing the diagnosis instead of a more invasive incision or excision biopsy.

Keywords

• Conjunctivitis
• fine needle aspiration cytology
• juvenile xanthogranuloma
• touton giant cell