Kakkassery V, Stübiger N, Adamietz I A, Tischoff I, Baraniskin A, Wunderlich I M
Augenklinik, Universitätsklinikum Knappschaftskrankenhaus Bochum, Ruhr-Universität Bochum, In der Schornau 23-25, 44892, Bochum, Deutschland,
Ophthalmologe. 2015 Mar;112(3):210-6. doi: 10.1007/s00347-014-3205-y.
Lymphomas of the ocular adnexa are heterogeneous and demonstrate a wide range of clinical, histological, immunohistochemical and molecular genetic characteristics.
The aim of this article is to give an overview of the interdisciplinary diagnostics and individually adapted lymphoma subtype-based therapy.
Depending on the lymphoma localisation, i.e. whether in the eyelid, the conjunctiva or in the orbit, a photograph or a radiological scan is required to record the tumor extent. Visual function is more likely to be impacted when the lymphoma arises in the posterior orbit, close to the optic nerve and imaging diagnostics are therefore necessary. Histological investigations are essential for confirming the lymphoma diagnosis and give information about the particular subtype, which in turn will determine subsequent patient management, Clinical staging investigations for determining the systemic extent of the lymphoma manifestation (e.g. imaging, blood analyses as well as bone marrow biopsy) are mandatory.
External beam radiation, local and systemic chemotherapy or in some cases antibiotics are treatment options after surgical excision in isolated ocular adnexal lymphoma. The TNM classification of the American Joint Committee on Cancer or the Ann Arbor staging system, as well as the guidelines of the German Society of Hematology and Medical Oncology are all tools to aid the choice of the appropriate individually adapted therapy for systemic disease, which includes psycho-oncological care.
眼附属器淋巴瘤具有异质性,表现出广泛的临床、组织学、免疫组化和分子遗传学特征。
本文旨在概述跨学科诊断及基于淋巴瘤亚型的个体化治疗。
根据淋巴瘤的定位,即位于眼睑、结膜还是眼眶,需要拍摄照片或进行放射学扫描以记录肿瘤范围。当淋巴瘤发生于眼眶后部靠近视神经处时,视觉功能更易受影响,因此影像学诊断必不可少。组织学检查对于确诊淋巴瘤及提供特定亚型的信息至关重要,而这反过来又将决定后续的患者管理。确定淋巴瘤表现的全身范围的临床分期检查(如影像学、血液分析以及骨髓活检)是必需的。
对于孤立性眼附属器淋巴瘤,手术切除后,外照射放疗、局部和全身化疗或在某些情况下使用抗生素是治疗选择。美国癌症联合委员会的TNM分类或安阿伯分期系统,以及德国血液学和医学肿瘤学会的指南,都是帮助选择适合全身性疾病的个体化治疗方案的工具,其中包括心理肿瘤学护理。