Case 1

An 84-year-old woman presented with a 4-month history of painless swelling of all 4 eyelids (Figure 1). On physical examination, the lids felt boggy, and each eye had pinkish-pale, lobular tissue covering almost the entire bulbar and palpebral conjunctiva (Figure 2). Generalized lymphadenopathy and mild normocytic, normochromic anemia were additional findings.

Case 2

A41-year-old woman complained of a scratchy sensation in her right eye of 3-months' duration. On external inspection, her eyes appeared normal, but raising the right upper lid unveiled a salmon-colored conjunctival mass (Figure 3). Physical examination was otherwise unremarkable, and results of conventional laboratory studies were normal.

Both patients have the same disease.