McKelvie P A, McNab A, Francis I C, Fox R, O'Day J
Department of Anatomical Pathology, St Vincent's Hospital, Fitzroy, Victoria, Australia.
Clin Exp Ophthalmol. 2001 Dec;29(6):387-93. doi: 10.1046/j.1442-9071.2001.d01-18.x.
This study involved 73 patients with lymphoproliferative lesions of the ocular adnexa. The lesions were categorized using the Revised European American Lymphoma classification of lymphoid tissues and analysed to determine the frequency and prognostic impact of tumour type, location, stage and patient's age and sex.
The clinical, histopathological, immunohistochemical and phenotypic analysis by flow cytometry and follow-up data were studied.
The ocular adnexal lymphoproliferative lesions included 70 lymphomas and six reactive lymphoid hyperplasia. Seventy-nine per cent had stage IE disease, 4% stage II, 1.5% stage III and 15.5% stage IV. Five patients (7%) had a past history of systemic lymphoma. Major histological types were extranodal marginal zone lymphoma (MZL) in 44 (63%), follicular (FL) in 12 (17%), diffuse large B-cell (DLBCL) in eight (11%), mantle cell (MCL) in two (3%), B-cell chronic lymphocytic leukaemia (CLL)/small lymphocytic lymphoma in two (3%), peripheral T-cell lymphoma (PTCL) one (1.5%) and natural killer cell lymphoma (NKCL) in one (1.5%). Longest survival was seen in those with low-grade lymphomas (MZL and FL) and worst in PTCL and NKCL. Lymphoma-related mortality was 2% for MZL, 33% for FL, 38% for DLBCL, and 100% for MCL, PTCL and NKCL. Systemic lymphoma was present prior to, at presentation or at subsequent follow up in 26/68 (39%) of all lymphoma patients, 17% for MZL, 38% for DLBCL, 83% for FL, and 100% for MCL, CLL, PTCL and NKCL.
The majority of ocular adnexal lymphomas were low-grade B-cell lymphomas (MZL). Multivariate analysis showed that the only significant independent predictors of all causes of mortality were the histological type of lymphoma and the stage of disease at presentation.
本研究纳入了73例眼附属器淋巴增殖性病变患者。采用修订的欧美淋巴瘤淋巴组织分类对病变进行分类，并分析肿瘤类型、位置、分期以及患者年龄和性别的频率及预后影响。
研究临床、组织病理学、免疫组织化学以及流式细胞术的表型分析和随访数据。
眼附属器淋巴增殖性病变包括70例淋巴瘤和6例反应性淋巴组织增生。79%为IE期疾病，4%为II期，1.5%为III期，15.5%为IV期。5例患者（7%）有全身淋巴瘤病史。主要组织学类型包括44例（63%）结外边缘区淋巴瘤（MZL）、12例（17%）滤泡性淋巴瘤（FL）、8例（11%）弥漫性大B细胞淋巴瘤（DLBCL）、2例（3%）套细胞淋巴瘤（MCL）、2例（3%）B细胞慢性淋巴细胞白血病（CLL）/小淋巴细胞淋巴瘤、1例（1.5%）外周T细胞淋巴瘤（PTCL）和1例（1.5%）自然杀伤细胞淋巴瘤（NKCL）。低级别淋巴瘤（MZL和FL）患者生存期最长，PTCL和NKCL患者最差。MZL的淋巴瘤相关死亡率为2%，FL为33%，DLBCL为38%，MCL、PTCL和NKCL为100%。在所有淋巴瘤患者中，26/68（39%）在初次就诊前、就诊时或随后随访时出现全身淋巴瘤，MZL为17%，DLBCL为38%，FL为83%，MCL、CLL、PTCL和NKCL为100%。
大多数眼附属器淋巴瘤为低级别B细胞淋巴瘤（MZL）。多变量分析显示，所有死亡原因的唯一显著独立预测因素是淋巴瘤的组织学类型和就诊时的疾病分期。
