Morris Jacob M, Lassaline Mary E, Nunnery Catherine M, Teixeira Leandro B C, Martins Bianca C, Moore Bret A, Knickelbein Kelly E, Scherrer Nicole M, Plummer Caryn E
College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA.
School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Equine Vet J. 2025 Jul;57(4):1028-1034. doi: 10.1111/evj.14446. Epub 2024 Nov 27.
Little information describing the biologic behaviour and therapies for corneal lymphoma exist.
To characterise histologically confirmed equine corneal lymphoma considering breed, age or sex predisposition, histologic and immunologic features, therapies and outcomes.
Retrospective case series.
A multicentre retrospective medical record review was used to identify horses that presented with corneal disease confirmed morphologically as corneal lymphoma from 2012 to 2022.
Mean age at diagnosis was 10.5 years. Males represented 18/26 cases. Warmblood (14) and Thoroughbred (6) breeds were most commonly represented. 25/26 had unilateral ocular involvement. No cases had evidence of multicentric lymphoma. Most eyes (77.7%) had a history of suspected immune-mediated keratitis (IMMK) or eosinophilic keratitis. Morphological diagnosis confirming lymphoma was available for all cases. B-cell lymphoma was diagnosed in 19/24 eyes for which immunohistochemistry was performed, with intermediate to large B-cell lymphoma being most common. Fifteen of 27 eyes received at least one form of adjunctive therapy following keratectomy. Four eyes, which did not receive adjunctive therapy following keratectomy, experienced recurrence. No horses treated with adjunctive therapy following keratectomy experienced recurrence. Malignant transformation of IMMK to lymphoma was morphologically documented in one eye and suspected in three others based on recurrence of clinical signs. All globes were retained and visualised at the last follow-up.
Incomplete medical records, owner subjectivity concerning onset of disease and cases being lost to follow-up.
Malignant transformation of IMMK to corneal lymphoma likely occurs in horses. Lymphoma should be a differential for nonulcerative keratitis in horses. Keratectomy and histopathology may be considered in progressive or refractory cases of IMMK to rule out neoplastic disease. Recurrence of corneal lymphoma is unlikely following excision and adjunctive therapy. Cases with large corneal surface area or deep stromal involvement may have a likelihood for recurrence.
关于角膜淋巴瘤的生物学行为和治疗方法的信息很少。
从品种、年龄或性别易感性、组织学和免疫学特征、治疗方法及结果等方面，对经组织学确诊的马角膜淋巴瘤进行特征描述。
回顾性病例系列研究。
采用多中心回顾性病历审查，以确定2012年至2022年间出现经形态学确诊为角膜淋巴瘤的角膜疾病的马匹。
诊断时的平均年龄为10.5岁。26例中有18例为雄性。最常见的品种是温血马（14例）和纯种马（6例）。26例中有25例为单眼受累。没有病例有多发淋巴瘤的证据。大多数眼睛（77.7%）有疑似免疫介导性角膜炎（IMMK）或嗜酸性粒细胞性角膜炎的病史。所有病例均有确诊淋巴瘤的形态学诊断。在进行免疫组织化学检查的24只眼中，有19只被诊断为B细胞淋巴瘤，其中中到大B细胞淋巴瘤最为常见。27只眼中有15只在角膜切除术后接受了至少一种辅助治疗。4只在角膜切除术后未接受辅助治疗的眼睛出现了复发。角膜切除术后接受辅助治疗的马匹均未复发。一只眼睛在形态学上记录了IMMK向淋巴瘤的恶性转化，另外三只基于临床症状的复发被怀疑发生了这种转化。在最后一次随访时，所有眼球均得以保留并可观察。
病历不完整、主人对疾病发病时间的主观判断以及病例失访。
IMMK向角膜淋巴瘤的恶性转化可能发生在马匹中。淋巴瘤应作为马非溃疡性角膜炎的鉴别诊断之一。对于IMMK的进展性或难治性病例，可考虑进行角膜切除术和组织病理学检查以排除肿瘤性疾病。角膜淋巴瘤切除并辅以治疗后不太可能复发。角膜表面积大或基质深层受累的病例可能有复发的可能性。
