Extranodal marginal zone B-cell lymphomas of mucosa-associated lymphoid tissue?type of the orbit and ocular adnexa

Lee, Jae‐Lyun; Kim, Minkyoung; Lee, Kyung Hee; Hyun, Myung Soo; Chung, Hwa Sun; Kim, Dong Suk; Shin, Sei One; Cho, Hee Soon; Bae, Sung Hwa; Ryoo, Hun Mo

doi:10.1007/s00277-004-0914-3

Cited by 101 publications

(75 citation statements)

References 27 publications

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“…Several publications have reported a total of 80 patients in whom no complementary treatment, and particularly no radiotherapy, was performed after surgical excision. 11,13,18,36,37,39,42,44,45,47,91 Some of these studies indicated that local relapse occurred more frequently after simple surgical excision than after radiotherapy. 18,42 However, this approach has not been fully evaluated; the outcome was clearly indicated for only 8 patients in these reports.…”

Section: Surgical Excision and Wait-and-see Policymentioning

confidence: 99%

“…37 A number of studies 11,13,18,16,27,30,36,39,[41][42][43][44][45][46][47]83,91 have reported treatment with chemotherapy alone or in combination with other modalities, but few have reported the response rates obtained with these treatments. 11,46,47,84,85 Lee et al 47 reported 3 patients who underwent CHOP chemotherapy, 2 of whom experienced complete remission. Sasai et al 46 observed no significant difference in cause-specific or overall survival rates for patients with MALT lymphoma treated with radiotherapy alone or with exclusive single-agent or combination chemotherapy.…”

Section: Chemotherapy Regimens and Oalmentioning

confidence: 99%

“…11,13,18,22,23,27,28,[36][37][38][39][40][41][42][43][44][45][46][47] However, a large majority of reported OALs-between 95% and 100% of reported casescorrespond to the B-cell type, and 80% of B-cell lymphomas are low grade. A major characteristic of OAL is the high incidence of marginal zone B-cell lymphoma or mucosa-associated lymphoid tissue (MALT) lymphoma, reported in approximately 50% of patients.…”

Section: Histopathologic Characteristics Of Oalmentioning

confidence: 99%

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Ocular adnexal lymphoma: a review of clinicopathologic features and treatment options

Decaudin

Crémoux

Vincent‐Salomon

et al. 2006

Blood

133

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IntroductionLymphoproliferations of the eye, including intraocular and ocular adnexal non-Hodgkin lymphoma (NHL), constitute a heterogeneous group of neoplasms that represent less than 1% of all NHLs 1 and 5% to 15% of all extranodal sites. 2 First described in 1952, 3 they are the most frequent malignant tumors of the eye and ocular adnexae; in fact, in the Florida cancer registry, they represent up to 55% of all orbital tumors. 4 As for all NHLs, a marked increase of the incidence of ocular adnexal NHL has also been observed. 4 The clinical features and natural history of ocular adnexal lymphoma (OAL) is completely different from those of intraocular lymphoma, which emphasizes the need to distinguish between the therapeutic management of both. Intraocular lymphoma is a subset of primary central nervous system lymphoma, 5-7 and intraocular involvement is found in approximately 15% of affected patients. 8 The histologic subtype of intraocular lymphoma is almost always high grade 9,10 and it can occur in the context ofAIDS-related lymphoproliferations. In contrast, OALs-including lesions of the conjunctiva, lacrimal gland, orbit, and eyelids-are mainly low-grade tumors not associated with HIV infection. 11 Although combination chemotherapy with highdose methotrexate is the basis of treatment of primary central nervous system and intraocular lymphomas, 10,12 radiotherapy has been the standard treatment for low-grade ophthalmologic lymphomas. [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] However, other treatment options, such as therapy with monoclonal anti-CD20 antibody, 31,32 may constitute a promising alternative to external beam irradiation and its potential toxicity. In addition, some reports have suggested a possible value of anti-Chlamydia psittaci antibiotic therapy. 33,34 In this review, which is exclusively focused on ophthalmologic lymphomas, we first present the pathologic, clinical, and prognostic factors of these lymphomas and then discuss all available treatment options in terms of safety and efficacy and their respective indications. Biology of ophthalmologic lymphomas Diagnosis of OALAs for all other forms of nodal and extranodal NHL, confirming a positive diagnosis of OAL is often long and difficult because the tumor is very small in most patients. Positive diagnosis must be based on histologic examination of a sufficient tumor sample obtained by surgical biopsy that is large enough to allow rigorous definition of lymphoproliferative disease according to the World Health Organization (WHO) classification. 35 Histopathologic examination consists of morphologic examination of cellular proliferation (cellular appearance and architectural pattern), usually combined with immunohistochemical analysis and molecular analysis.The exact modalities of biopsy depend on the anatomic site of the lesion and its relation to the eye: biopsy may be performed of the conjunctiva, an eyelid lesion, an orbital mass, or the lacrimal gland. However, sometimes patients have nodal involvement, an...

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Section: Surgical Excision and Wait-and-see Policymentioning

confidence: 99%

Section: Chemotherapy Regimens and Oalmentioning

confidence: 99%

Section: Histopathologic Characteristics Of Oalmentioning

confidence: 99%

See 1 more Smart Citation

Ocular adnexal lymphoma: a review of clinicopathologic features and treatment options

Decaudin

Crémoux

Vincent‐Salomon

et al. 2006

Blood

133

View full text Add to dashboard Cite

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“…Despite resolution of the tumor after irradiation, supraduction limitation was not improved, suggesting that irradiation led not only to tumor cell death, but also subsequent irreversible muscle fibrosis. It was previously reported that the most common site of ocular EMZL was the conjunctiva (51%), while extraocular muscles were the most rare localization (only 5%) (1). A review the literature revealed only 9 cases of orbital lymphoma invading the superior rectus muscle, in which, histologically, EMZL was not included (2-5) (Table I).…”

Section: Discussionmentioning

confidence: 99%

Extranodal marginal zone B-cell lymphoma involving superior rectus muscle: A clinicopathological case report

et al. 2011

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Abstract.A 66-year-old female had suffered from proptosis in the left eye (OS) and double vision for 1 month due to abnormality of the superior rectus muscle. Visual acuity was noted as 20/20 in both eyes (OU). Eye movement showed limited OS supraduction. Magnetic resonance imaging revealed an indistinct mass in the orbit involving the superior rectus muscle. A biopsy specimen of the orbital tumor led to the histological diagnosis of extranodal marginal zone B-cell lymphoma. Radiotherapy with a total dosage of 30 Gy was administered, which subsequently resolved the tumor. However, the supraduction limitation of ocular movement remained unchanged. Supraduction limitation is due to muscular contraction disorder of the superior rectus muscle, caused by direct lymphoma cell invasion.

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“…This case was an EBV-negative lymphoma and the disease extent was limited to the eye; therefore, we decided that a local radiotherapy would be the treatment modality because radiotherapy is one of the competent options among the treatment modalities for orbital MALT lymphoma (21)(22)(23)(24)(25). Recent studies reported that a radiotherapy dose range of 25∼35 Gy achieved ex-cellent survival rates for stage IEA orbital MALT lymphoma (26). In addition, we changed tacrolimus to sirolimus for its anti-proliferative effect.…”

Section: Case Reportmentioning

confidence: 99%

Bilateral Conjunctival Mucosa-Associated Lymphoid Tissue Type Lymphoma in a Kidney Transplant Recipient

Chang

Yang

et al. 2018

Korean J Transplant

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Lymphoproliferative disorder in a posttransplant setting has emerged as a difficult problem in kidney transplantation (KT).Lymphoma involving adnexa of the eye has rarely been reported due to scarcity of lymphoreticular tissue in the ocular area. This report presents a case of a 37-year-old KT recipient who was diagnosed with conjunctival mucosa-associated lymphoid tissue lymphoma with a chief complaint of seeing black spots. Unlike other post-transplant lymphoproliferative diseases associated with the Epstein-Barr virus (EBV) reactivation via immunosuppression, the lesion was not related to the virus. The patient received radiotherapy with concomitant conversion from the tacrolimus to the sirolimus. Overall, the results presented herein indicate lymphoma may be an important differential diagnosis when KT recipients complain of ocular discomfort. Case Report INTRODUCTIONKidney transplantation (KT) is an emerging option for renal replacement therapy that improves the quality of life, as compared to dialysis. However, immunosuppressive therapy for the prevention of rejection can lead to lymphoproliferative disease after KT up to 1% to 20%(1). The extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT) type that belonged to the indolent B-cell lymphomas which is mainly an observed gastric mucosa and it is associated with the Helicobacter pylori infection(2-5), has been rarely reported as originating from other sites. We herein report a case of a KT recipient who is diagnosed with extranodal marginal zone lymphoma involving both conjunctivae. CASE REPORTA 37-year-old woman with end-stage renal disease due to lupus nephritis received a living-donor KT after 5 years of peritoneal dialysis. The donor was her mother, and the human leukocyte antigen mismatch number was 2. She underwent induction therapy by using basiliximab, and thereafter maintained immunosuppression with tacrolimus, mycophenolic acid, and deflazacort. The trough level of tacrolimus has been maintained between 4∼5 ng/mL. The allograft function was kept stable with an estimated glomerular filtration rate of 60 mL/min/1.73 m Cytomegalovirus and Epstein-Barr virus (EBV) were not detected in the real-time polymerase chain reaction test. In the ophthalmic examination, multiple cystic nodules located in both lower conjunctivae were found. The cystic nodules were biopsied and diagnosed with extranodal marginal zone lymphoma of MALT type (Fig. 1). During the staging workup for lymphoma, orbital magnetic resonance imaging and positron emission tomography computed tomography (PET-CT) showed hypertrophic changes in the lower conjunctivae of both eyes and tonsils (Fig. 2). The bone marrow finding was normal, and the chromosome analysis of hematology/oncology showed no atypical clone. The stain for EBV was negative. The patient also underwent esophagogastroduodenoscopy with a negative result of H. pylori It is generally known that MALT lymphoma most frequently develops in the stomach due to the H. pylori infection(12). Only rare nongastric MA...

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Extranodal marginal zone B-cell lymphomas of mucosa-associated lymphoid tissue?type of the orbit and ocular adnexa

Cited by 101 publications

References 27 publications

Ocular adnexal lymphoma: a review of clinicopathologic features and treatment options

Ocular adnexal lymphoma: a review of clinicopathologic features and treatment options

Extranodal marginal zone B-cell lymphoma involving superior rectus muscle: A clinicopathological case report

Bilateral Conjunctival Mucosa-Associated Lymphoid Tissue Type Lymphoma in a Kidney Transplant Recipient

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