Unifocal and Multifocal Reactive Lymphoid Hyperplasia vs Follicular Lymphoma of the Ocular Adnexa

A correct diagnosis of RLH vs follicular lymphoma can be reliably established employing immunohistochemical methods. A heretofore undescribed “multifocal RLH” syndrome must be distinguished from follicular lymphoma. Conjunctival RLH can usually be managed surgically without radiotherapy, but “multifocal RLH” required systemic treatment in 2 of 3 patients. Follicular lymphoma requires systemic chemotherapy if discovered beyond stage 1E.