Mucosa-associated lymphoid tissue (MALT) in the human conjunctiva (original) (raw)
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Canadian Journal of Ophthalmology / Journal Canadien d'Ophtalmologie, 2006
Background: Conjunctival lymphoproliferative lesions have not been selected for independent analysis with newer immunohistochemical and molecular genetic techniques to highlight their unique profile. Methods: Retrospective case series examined biopsies from 16 consecutive patients with conjunctival lymphoproliferative lesions. The histopathologic, immunohistochemical, and molecular genetic features were characterized, as well as the frequency of tumour type, prognostic implications, clinical features, and treatments offered. Results: The diagnosis was lymphoma in 12 cases, atypical lymphoid hyperplasia (ALH) in 1 case, and reactive lymphoid hyperplasia (RLH) in 3 cases. The primary lymphomas consisted of 4 mucosa-associated lymphoid tissue lymphomas (MALTL), 1 follicular lymphoma (FL), 2 diffuse large B-cell lymphomas (DLBCLs), 1 lymphoplasmacytic lymphoma, and 1 T-cell lymphoma. Primary lymphomas were treated with radiation (n = 7), surgery (n = 1), and topical chemotherapy (n = 1). Complete remission was achieved in 8 of 9 primary lymphomas. Two cases of recurrence to the other conjunctiva were treated with radiation and both remained disease free. Secondary lymphomas included 2 DLBCL and 1 MALTL. Complete remission was seen in 2 patients after radiation plus chemotherapy, while the patient treated with chemotherapy alone was lost to follow-up. The 1 case of ALH presented bilaterally and achieved complete remission after topical chemotherapy treatments. The 3 RLH cases were surgically managed and 2 of the 3 recurred and were subsequently excised. Eleven lymphomas were of B-cell lineage by immunophenotyping. Molecular genetic studies of immunoglobulin heavy chain (IgH) gene rearrangement by polymerase chain reaction (PCR) showed clonal bands in 6 of 12 lymphomas, 1 of 3 RLH (polyclonal by immunophenotyping) and 1 ALH. BCL2-IgH [t(14;18)] rearrangement was seen in 8 of 12 cases (1 FL, 3 DLBCLs, 4 MALTLs) by real-From
Clinical Nuclear Medicine, 2014
A 67-year-old woman was referred for staging of a mucosa-associated lymphoid tumor lymphoma involving the left conjunctiva. CT scan had shown paravertebral and pelvic masses, and a breast nodule. FDG PET/CT demonstrated moderately increased uptake in the left ocular conjunctiva and confirmed the paravertebral and pelvic masses and the breast nodule. Moreover, abnormal FDG uptake was shown in 2 breast nodules, the flank, the gluteus maximus, and the gastric cardia. The patient received 6 cycles of rituximab-bendamustine chemotherapy with a complete clinical and metabolic response at the 6-month follow-up PET/CT and remained relapse-free without visual acuity problem after a 36-month follow-up. FIGURE 1. A, Baseline FDG PET/CT showing increased glucose analog in the left conjunctiva (arrow) as compared with the contralateral side (left-to-right SUV ratio, 3.0). B, Control after 3 of 6 cycles of chemotherapy showing an excellent metabolic response with normalized left-to-right SUV ratio to 1.0 (arrowhead).
Middle East African Journal of Ophthalmology , 2024
PURPOSE: To report the clinical presentation, histopathological and immunohistological features of conjunctival lymphatic–venous lesions. METHODS: This was a retrospective review of 15 patients with symptomatic conjunctival lymphatic–venous lesions. The clinical features and histopathologic features of the excised tissues were reviewed. Immunohistochemical staining with antibodies against CD34 to label vascular endothelium and D2‑40 to label lymphatic endothelium was performed. RESULTS: All patients had unilateral conjunctival involvement. The mean age was 48.9 ± 18.9 years, with more women affected (67%). No patient had impaired visual acuity secondary to the lesion. The location of the lesion was temporal in 67% of patients. The presenting symptoms included conjunctival swelling, discomfort and/or foreign‑body sensation, and tearing. All lesions were excised, and none recurred. All excised lesions showed dilated channels that were lined by a flattened endothelium staining positive with CD34, surrounded by edematous lamina propria. Larger ectatic lymphatic channels demonstrated scattered D2‑40 staining in the endothelial cell lining and patchy CD34 staining within the endothelial cell cytoplasm. D2‑40 and CD‑34 immunoreactivity did not overlap in the same cells. CONCLUSION: The clinical features and outcomes of the lesions in this large cohort were similar to those reported in the literature. However, the mixed immunoreactivity of the endothelial cells lining these ectatic lymphatic channels in the conjunctiva suggests that these channels are lymphatic–venous lesions. We suggest that these channels be termed conjunctival lymphaticovenous malformation rather than lymphangiectasia, which suggests ectasia of existing lymphatics. Future studies are needed to understand these lesions and their histopathologic origins.
PloS one, 2014
Orbital marginal zone B-cell lymphoma (OAML) constitutes for the most frequent diagnosis in orbital lymphoma. Relatively little data, however, have been reported in larger cohorts of patients staged in a uniform way and no therapy standard exists to date. We have retrospectively analyzed 60 patients diagnosed and treated at our institution 1999-2012. Median age at diagnosis was 64 years (IQR 51-75) and follow-up time 43 months (IQR 16-92). All patients had undergone uniform extensive staging and histological diagnosis was made by a reference pathologist according to the WHO classification. The majority of patients presented with stage IE (n = 40/60, 67%), three had IIE/IIIE and the remaining 17 stage IVE. Seven patients with IVE had bilateral orbital disease whereas the others showed involvement of further organs. Treatment data were available in 58 patients. Local treatment with radiotherapy (14/58, 24%) or surgery (3/58, 5%) resulted in response in 82% of patients. A total of 26 p...