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[眼及眼周组织淋巴瘤——临床病理相关性]

[Lymphoma of Ocular and Periocular Tissues - Clinicopathological Correlations].

作者信息

Schmack I, Grossniklaus H E, Hartmann S

机构信息

Klinik für Augenheilkunde, Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt am Main.

L.F. Montgomery Laboratory, Emory Eye Center, Emory University, Atlanta, Georgia, United States.

出版信息

Klin Monbl Augenheilkd. 2016 Jul;233(7):824-46. doi: 10.1055/s-0042-110574. Epub 2016 Jul 28.

Abstract

Lymphomas of the ocular adnexa and intraocular tissue include a wide range of lymphoproliferative neoplastic disorders. They are predominantly extranodal non-Hodgkin lymphomas (NHL). The World Health Organization (WHO) classification of lymphoid neoplasm and individual morphological, immunophenotypical, and molecular genetic features, indicate that they may be divided into B-cell (approximately 80 % of all NHL) and T-cell lymphomas (approximately 10-20 % of all NHL). The most common forms of ocular NHL are extranodal marginal zone lymphoma (EMZL) of the mucosa-associated lymphoid tissue (MALT-type), follicular lymphoma (FL), diffuse large B-cell lymphoma, and mantel cell lymphoma. The clinical signs and symptoms are usually very unspecific and depend on the location, size, and extent of the underlying lymphoma subtype. Typical low grade lymphomas have an indolent clinical course and often remain unrecognized for many years. On the other hand, high grade NHLs, such as DLBCL or MCL, are frequently aggressive, with rapid tumour growth and poor prognosis, despite early detection. Histopathology is still the gold standard in the diagnosis of ocular lymphomas. Basic understanding of the principal pathophysiological and clinical aspects of the development and progression of orbital and ocular lymphomas seems to be mandatory for optimal diagnosis and treatment and for improving survival and prognosis. Both residents in training and board certified ophthalmologists should be aware of these problems.

摘要

眼附属器和眼内组织淋巴瘤包括多种淋巴增殖性肿瘤性疾病。它们主要是结外非霍奇金淋巴瘤(NHL)。世界卫生组织(WHO)对淋巴样肿瘤的分类以及个体的形态学、免疫表型和分子遗传学特征表明,它们可分为B细胞淋巴瘤(约占所有NHL的80%)和T细胞淋巴瘤(约占所有NHL的10%-20%)。眼NHL最常见的形式是黏膜相关淋巴组织(MALT型)的结外边缘区淋巴瘤(EMZL)、滤泡性淋巴瘤(FL)、弥漫性大B细胞淋巴瘤和套细胞淋巴瘤。临床体征和症状通常非常不具特异性,取决于潜在淋巴瘤亚型的位置、大小和范围。典型的低级别淋巴瘤临床病程缓慢,往往多年未被发现。另一方面,高级别NHL,如弥漫性大B细胞淋巴瘤或套细胞淋巴瘤,尽管早期发现,但通常具有侵袭性,肿瘤生长迅速且预后较差。组织病理学仍然是眼淋巴瘤诊断的金标准。对眼眶和眼淋巴瘤发生和进展的主要病理生理和临床方面有基本了解,对于优化诊断和治疗以及改善生存和预后似乎是必不可少的。住院医师和获得委员会认证的眼科医生都应该意识到这些问题。

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