Conjunctival lymphomas in Japanese monozygotic twins: A case report

Ishibashi,Naoya; Sugaya,Satoshi; Takahashi,Hiromichi; Nishimaki,Haruna; Nakanishi,Yoko; Chinen,Yoshiaki; Maebayashi,Toshiya

doi:10.3892/ol.2018.9723

Conjunctival lymphomas in Japanese monozygotic twins: A case report

Authors:
- Naoya Ishibashi
- Satoshi Sugaya
- Hiromichi Takahashi
- Haruna Nishimaki
- Yoko Nakanishi
- Yoshiaki Chinen
- Toshiya Maebayashi
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Affiliations: Department of Radiology, Nihon University School of Medicine, Tokyo 173‑8610, Japan, Division of Ophthalmology, Department of Visual Sciences, Nihon University School of Medicine, Tokyo 173‑8610, Japan, Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo 173‑8610, Japan, Department of Oncologic Pathology, Nihon University School of Medicine, Tokyo 173‑8610, Japan, Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto 602‑8566, Japan
Published online on: November 16, 2018 https://doi.org/10.3892/ol.2018.9723
Pages: 1313-1319

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Abstract

An individual with a twin who has developed leukemia or non‑Hodgkin lymphoma (NHL) has an increased risk of developing the same disease, particularly with monozygotic twins. The few reported pairs of twins who developed NHL had similar primary sites and pathological subtypes. Here, we present the first reported cases of primary conjunctival NHL in both female monozygotic twins. Twin 1 was diagnosed with an extranodal marginal zone lymphoma (EMZL; Ann Arbor stage IE) in the right conjunctiva at 25 years old and a subsequent tumor in the left conjunctiva at 39 years, and was also histopathologically diagnosed as EMZL. No infiltration of other organs was detected and both lesions were surgically excised. At the age of 40 years, Twin 2 was diagnosed with an EMZL (Ann Arbor stage IE) in the right conjunctiva without infiltration of other organs and was treated with external beam radiation therapy rather than surgery. Complete remission was achieved in both twins; neither developed conjunctival recurrences. This study highlights the importance of examining the other, apparently healthy twin when one twin develops conjunctival lymphoma.

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