Vali Khojeini Elham, Durham Benjamin H, Chen Mingyi
Department of Pathology and Laboratory Medicine, School of Medicine, University of California, Davis, 4400 V Street, Sacramento, CA 95817, USA.
Case Rep Pathol. 2013;2013:581856. doi: 10.1155/2013/581856. Epub 2013 Apr 4.
Orbital and ocular adnexal lymphomas are rare and represent around 1-2% of lymphomas and about 8% of the extranodal lymphomas. However, these entities represent the majority of orbital malignancies. Lymphomas of the ocular adnexal region are primary or secondary lymphomas, and the majority of them are composed of small, mature lymphocytes, which provide a large differential diagnosis. Thus, these entities are not easily distinguished from indolent lymphoid processes such as reactive lymphoid hyperplasia. Extranodal marginal zone lymphoma is the most common lymphoma in the ocular adnexal region. However, this entity cannot be distinguished from benign lymphoid proliferations or other lymphomas composed of small, mature lymphocytes by routine histopathology. We describe a 78-year-old man who presents with bilateral upper eyelid masses, which had been present and grew in size over the past twelve months prior to his presentation. A biopsy of the mass shows a monotonous population of small, mature lymphocytes. The immunohistochemical studies performed on the eyelid mass confirmed a monoclonal proliferation of B cells expressing cyclin-D1; therefore, a final diagnosis of mantle cell lymphoma was rendered. A literature review of mantle cell lymphoma with orbital and ocular adnexal involvement and the diagnostic pitfalls in this area of hematopathology are discussed.
眼眶及眼附属器淋巴瘤较为罕见，约占淋巴瘤的1%-2%，占结外淋巴瘤的8%左右。然而，这些病变却是眼眶恶性肿瘤的主要类型。眼附属器区域的淋巴瘤为原发性或继发性淋巴瘤，其中大多数由小的成熟淋巴细胞组成，这使得鉴别诊断范围很广。因此，这些病变不易与反应性淋巴组织增生等惰性淋巴样病变相区分。结外边缘区淋巴瘤是眼附属器区域最常见的淋巴瘤。然而，通过常规组织病理学无法将该病变与良性淋巴组织增生或其他由小的成熟淋巴细胞组成的淋巴瘤区分开来。我们报告一名78岁男性，双侧上睑肿物，在就诊前12个月内出现并逐渐增大。肿物活检显示小的成熟淋巴细胞单一性增生。对眼睑肿物进行的免疫组化研究证实表达细胞周期蛋白D1的B细胞单克隆增殖；因此，最终诊断为套细胞淋巴瘤。本文讨论了眼眶及眼附属器受累的套细胞淋巴瘤的文献综述以及血液病理学该领域的诊断陷阱。
