Nakata M, Matsuno Y, Katsumata N, Takenaka T, Kobayashi Y, Narabayashi M, Kagami Y, Ikeda H, Kaneko A, Tobinai K
Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.
Leuk Lymphoma. 1999 Feb;32(5-6):533-43. doi: 10.3109/10428199909058411.
Lymphoid infiltrates in the ocular adnexa are mostly low-grade B-cell lymphoma, but their clinicopathologic characteristics and prognostic factors have not been extensively analyzed according to the Revised European-American Lymphoma (REAL) Classification. We reviewed histopathologic sections from 77 patients with primary ocular adnexal lymphoid infiltrates, and conducted univariate and multivariate analyses of possible prognostic factors. Fifty-seven of the 77 patients were confirmed to have malignant lymphoma. Histopathologic sections from 44 of the 57 patients were reclassified into the following categories; marginal zone lymphoma (MZL) in 35, mantle cell lymphoma (MCL) in two, diffuse large cell lymphoma (DLCL) in six, and lymphoplasmacytoid lymphoma (LPL) in one. In the remaining 13 patients, biopsied specimens were inadequate for further subclassification. The cause-specific survival rates of the 57 patients with primary ocular adnexal lymphoma at 5, 10, and 15 years were 90.1%, 84.8% and 84.8%, respectively. The univariate analysis showed that the clinical stage, serum lactate dehydrogenase (LDH) value and histopathologic subtype were significant. The 5-year cause-specific survival rate of the 35 patients with MZL was 100%, whereas that of the eight patients with non-MZL (DLCL and MCL) was 25% (p<0.0001). The multivariate analysis revealed that the histologic subtype (p=0.010) and serum LDH value (p=0.015) were independent significant predictors of survival. We conclude that malignant lymphomas occurring in the ocular adnexa histologically consist mostly of MZL. The histologic subtype according to the REAL Classification significantly predicts the prognosis of ocular adnexal lymphoma.
眼附属器的淋巴样浸润大多为低度B细胞淋巴瘤，但根据欧美淋巴瘤修订分类（REAL分类），其临床病理特征和预后因素尚未得到广泛分析。我们回顾了77例原发性眼附属器淋巴样浸润患者的组织病理学切片，并对可能的预后因素进行了单因素和多因素分析。77例患者中有57例被确诊为恶性淋巴瘤。57例患者中44例的组织病理学切片被重新分类如下：边缘区淋巴瘤（MZL）35例，套细胞淋巴瘤（MCL）2例，弥漫大B细胞淋巴瘤（DLCL）6例，淋巴浆细胞淋巴瘤（LPL）1例。其余13例患者的活检标本不足以进行进一步的亚分类。57例原发性眼附属器淋巴瘤患者5年、10年和15年的病因特异性生存率分别为90.1%、84.8%和84.8%。单因素分析显示，临床分期、血清乳酸脱氢酶（LDH）值和组织病理学亚型具有显著性。35例MZL患者的5年病因特异性生存率为100%，而8例非MZL（DLCL和MCL）患者的5年病因特异性生存率为25%（p<0.0001）。多因素分析显示，组织学亚型（p=0.010）和血清LDH值（p=0.015）是生存的独立显著预测因素。我们得出结论，眼附属器发生的恶性淋巴瘤在组织学上大多由MZL组成。根据REAL分类的组织学亚型显著预测眼附属器淋巴瘤的预后。
