Clinicopathologic Assessment of Ocular Adnexal Lymphoproliferative Lesions at a Tertiary Eye Hospital in IranClinicopathologic Assessment of Ocular Adnexal Lymphoproliferative Lesions at a Tertiary Eye Hospital in Iran
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Creator Fahimeh Asadi-Amoli
Title Clinicopathologic Assessment of Ocular Adnexal Lymphoproliferative Lesions at a Tertiary Eye Hospital in IranClinicopathologic Assessment of Ocular Adnexal Lymphoproliferative Lesions at a Tertiary Eye Hospital in Iran
Publisher APJCP
Publication Year 2559
Journal Title Asian Pacific Journal of Cancer Prevention
Journal Vol. 17
Journal No. 8
Page no. 3727-3731
Keyword Ocular adnexal lymphoproliferative disease , immunohistochemistry , pathology , lymphoma
Abstract Background: The most common type of ocular lymphoma is non-Hodgkin lymphoma (NHL), categorizedinto two groups: indolent (slow growing) and aggressive (rapid growing). Differentiating benign reactivelymphoid hyperplasia (RLH) from malignant ocular adnexal lymphoma (OAL) is challenging. Histopathology,immunohistochemistry (IHC) and flow cytometry have been used as diagnostic tools in such cases. Materialsand Methods: In this retrospective case series, from 2002 to 2013 at Farabi Eye Center, 110 patients with ocularlymphoproliferative disease were enrolled. Prevalence, anatomical locations, mean age at diagnosis and the finaldiagnosis of the disease with IHC were assessed. Comparison between previous pathologic diagnoses and resultsof IHC was made. Immunoglobulin light chains and B-cell and T-cell markers and other immuno-phenotypingmarkers including CD20, CD3, CD5, CD23, CD10, CYCLIND1 and BCL2 were evaluated to determine the mostaccurate diagnosis. The lymphomas were categorized based on revised European-American lymphoma (REAL)classification. Results: Mean age ? SD (years) of the patients was 55.6 ? 19.3 and 61% were male. Patients withfollicular lymphoma, large B-cell lymphoma or chronic lymphocytic leukemia/small cell lymphoma (CLL/SLL)tended to be older. Nine patients with previous diagnoses of low grade B-cell lymphoma were re-evaluated by IHCand the new diagnoses were as follows: extranodal marginal zone lymphoma(EMZL) (n=1), SLL(n=1), mantlecell lymphoma (MCL) (n=3), reactive lymphoid hyperplasia RLH (n=2). Two cases were excluded due to poorblocks. Flow cytometry reports in these seven patients revealed SLL with positive CD5 and CD23, MCLwithpositive CD5 and CyclinD1 and negative CD23, EMZL with negative CD5,CD23 and CD10. One RLH patientwas negative for Kappa/Lambda and positive for CD3 and CD20 and the other was positive for all of the lightchains, CD3 and CD20. Orbit (49.1%), conjunctiva (16.1%) and lacrimal glands (16.1%) were the most commonsites of involvement. Conclusions: Accurate pathological classification of lesions is crucial to determine propertherapeutic approaches. This can be achieved through precise histologic and IHC analyses by expert pathologists.
Asian Pacific Journal of Cancer Prevention

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