Primary anaplastic lymphoma kinase-positive large B-cell lymphoma of the left bulbar conjunctiva: A case report

Figure 1 Anterior segment image showed an 8 mm slightly elevated, sessile, pink-colored sub-epithelial mass described as a “salmon patch” in the conjunctival sac of the left eye.

Figure 2 Anaplastic lymphoma kinase-positive large B-cell lymphoma. A: The tumor was well-demarcated and showed a diffusely infiltrate of monomorphicatypical lymphoid cells in the stroma of the conjunctival subepithelial [hematoxylin and eosin (HE) ×100]; B: The accessory lacrimal glands were involved (HE × 400); C: The lymphoid cells displayed immunoblastic morphology (HE × 1000); D: The lymphoid cells with plasmablastic morphology (HE × 1000); E: the pleomorphic neoplastic giant cells were present focally (HE × 400); F: Necrosis, abundant apoptotic debris and haemorrhage were observed (HE × 400).

Figure 3 Immunohistochemical stains of anaplastic lymphoma kinase-positive large B-cell lymphoma (× 400). A-G: The large atypical cells were diffusely positive for anaplastic lymphoma kinase with a characteristic cytoplasmic granular staining pattern (A), CD10 (B), CD138 (C), BOB.1 (D), OCT-2 (E), CD4 (F) and EMA (G); H-J: Focally positive for CD79a (H) and IgA (I); negative for CD20 (J).