A 35-year-old man with advanced HIV (CD4 count 50 cells/µL) presents with bilateral elevated, sessile, hyperaemic conjunctival lesions that bleed on touch. The most likely diagnosis is:
- A Conjunctival lymphoma
- B Kaposi sarcoma of the conjunctiva ✓
- C Squamous cell carcinoma of the conjunctiva
- D Conjunctival intraepithelial neoplasia
Correct answer: B. Kaposi sarcoma of the conjunctiva
Explanation
Kaposi sarcoma of the conjunctiva presents as elevated, hyperaemic, vascular lesions that bleed easily in immunocompromised patients, especially with CD4 below 200. It is associated with HHV-8. Conjunctival lymphoma is typically salmon-pink and flat. Squamous cell carcinoma and CIN are more common in older, immunocompetent individuals and present differently. In advanced HIV, Kaposi sarcoma must be high on the differential.
Reference: Harrison's Principles of Internal Medicine / Parson's Diseases of the Eye, Standard ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.