眼附属器淋巴瘤——黏膜相关淋巴组织淋巴瘤与其他组织学类型的比较
Ocular adnexal lymphoma-comparison of MALT lymphoma with other histological types.
作者信息
Cahill M, Barnes C, Moriarty P, Daly P, Kennedy S
机构信息
The Research Foundation, The Royal Victoria Eye and Ear Hospital, Dublin 2, Republic of Ireland.
出版信息
Br J Ophthalmol. 1999 Jun;83(6):742-7. doi: 10.1136/bjo.83.6.742.
AIMS
To correlate histological features of ocular adnexal lymphoma using the revised European American lymphoma classification (REAL), with stage of disease at presentation, treatment modalities, and patient outcome. MALT lymphoma defines an extranodal marginal zone B cell lymphoma as outlined in the REAL classification. Comparison groups of patients included those with primary ocular adnexal MALT lymphoma versus primary ocular adnexal lymphomas of other types, MALT lymphoma versus non-MALT lymphomas (primary and secondary), and primary ocular adnexal lymphoma (MALT lymphomas and other types) versus secondary ocular adnexal lymphomas.
METHODS
A retrospective review of the National Ophthalmic Pathology Laboratory records identified 20 cases of ocular adnexal lymphoma over a 10 year period which were reclassified using appropriate immunohistochemical stains. Patients' medical records were examined for data including stage of the disease at presentation, mode of treatment, and patient outcome.
RESULTS
Among the 20 cases identified 14 had primary ocular adnexal lymphomas. 10 of the primary lymphomas had histological features of MALT lymphoma. One case was a primary ocular adnexal T cell lymphoma, one a follicular centre, follicular B cell lymphoma, and two were large cell B cell lymphomas. Six cases had systemic disease, four large B cell, one follicular centre, follicular B cell, and one mantle cell. A significantly higher proportion of patients with MALT lymphomas had early disease (p = 0.005), initially required local treatment (p = 0.005) and were alive at last follow up (p = 0.001) than those without. Two patients with MALT lymphoma had recurrence of lymphoma which responded to further treatment.
CONCLUSIONS
Patients with primary ocular adnexal MALT lymphomas present with localised disease requiring local treatment and have a better outcome compared with patients with other types. As a small percentage of these tumours recur, patients should be followed up indefinitely.
目的
运用修订后的欧美淋巴瘤分类（REAL），将眼附属器淋巴瘤的组织学特征与疾病初诊时的分期、治疗方式及患者预后进行关联分析。MALT淋巴瘤定义为REAL分类中所概述的结外边缘区B细胞淋巴瘤。患者的比较组包括原发性眼附属器MALT淋巴瘤患者与其他类型的原发性眼附属器淋巴瘤患者、MALT淋巴瘤与非MALT淋巴瘤（原发性和继发性），以及原发性眼附属器淋巴瘤（MALT淋巴瘤和其他类型）与继发性眼附属器淋巴瘤患者。
方法
对国家眼科病理实验室记录进行回顾性研究，在10年期间确定了20例眼附属器淋巴瘤病例，并使用适当的免疫组织化学染色进行重新分类。检查患者的病历以获取包括疾病初诊时的分期、治疗方式和患者预后等数据。
结果
在确定的20例病例中，14例为原发性眼附属器淋巴瘤。其中10例原发性淋巴瘤具有MALT淋巴瘤的组织学特征。1例为原发性眼附属器T细胞淋巴瘤，1例为滤泡中心滤泡性B细胞淋巴瘤，2例为大细胞B细胞淋巴瘤。6例有全身疾病，4例为大B细胞淋巴瘤，1例为滤泡中心滤泡性B细胞淋巴瘤，1例为套细胞淋巴瘤。与非MALT淋巴瘤患者相比，MALT淋巴瘤患者中疾病早期的比例显著更高（p = 0.005），最初需要局部治疗的比例显著更高（p = 0.005），且在最后一次随访时仍存活的比例显著更高（p = 0.001）。2例MALT淋巴瘤患者淋巴瘤复发，经进一步治疗后有反应。
结论
与其他类型的患者相比，原发性眼附属器MALT淋巴瘤患者表现为局限性疾病，需要局部治疗，且预后较好。由于这些肿瘤中有一小部分会复发，因此应对患者进行无限期随访。
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