Bilateral Conjunctival Extranodal Marginal Zone Lymphoma of Mucosa-Associated Lymphoid Tissue: A Case Report Highlighting Systemic Therapy as an Alternative and Review of Literature.

Abstract: Conjunctival extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) is a rare, indolent non-Hodgkin lymphoma that presents with distinct clinical and pathological features. This report describes a 31-year-old male who presented with progressive blurred vision and discomfort in the left eye. Examination revealed a conjunctival mass with a "salmon-patch" appearance, and subsequent histopathology confirmed low-grade MALT lymphoma. Despite recommendations for surgery and radiotherapy, the patient opted for systemic therapy with Rituximab and Bendamustine, achieving complete metabolic remission with significant clinical improvement. This case underscores the importance of early recognition of conjunctival lymphomas and demonstrates systemic therapy as a viable alternative when local treatments are declined. Keywords: Conjunctival lymphoma, Extra nodal marginal zone lymphoma, Mucosa-associated lymphoid tissue (MALT), Conjunctival MALT lymphoma, Systemic therapy, Rituximab, Ocular lymphoma, non-Hodgkin lymphoma, Conjunctival neoplasms.