Garner A, Rahi A H, Wright J E
Br J Ophthalmol. 1983 Sep;67(9):561-9. doi: 10.1136/bjo.67.9.561.
A prospective immunological study of patients with proptosis due to intraorbital lesions composed largely or exclusively of lymphoid tissue indicates that the use of antisera to specific heavy and light chain antibody components can be helpful in distinguishing between polyclonal and truly neoplastic monoclonal disorders. On the basis of combined histological and immunological information it is possible to delineate 4 categories of patient: those with unequivocal chronic inflammation, those with a virtually pure lymphoproliferative lesion and a polyclonal profile, and those with a monoclonal lymphomatous disorder which may be histologically comparable to the previous category or, in a fourth group, be unmistakably malignant on cytological grounds. The first of these groups will normally respond to corticosteroid treatment, but the others, including the polyclonal lymphoproliferative masses, need radiotherapy. The finding of reduced numbers of circulating T cells in the presence of low plasma levels of IgA, and of autoantibodies in the serum of a third of the patients, could mean that individuals developing lymphoproliferative lesions in the orbit, whether hyperplastic or neoplastic, are partially immunodeficient.
一项针对主要或完全由淋巴组织构成的眶内病变所致眼球突出患者的前瞻性免疫学研究表明，使用针对特定重链和轻链抗体成分的抗血清有助于区分多克隆和真正的肿瘤性单克隆疾病。根据组织学和免疫学综合信息，可将患者分为4类：明确患有慢性炎症的患者；具有几乎纯的淋巴增殖性病变且呈多克隆特征的患者；具有单克隆淋巴瘤性疾病的患者，其在组织学上可能与前一类相似，或者在第四组中，根据细胞学依据可明确为恶性。第一组患者通常对皮质类固醇治疗有反应，但其他组，包括多克隆淋巴增殖性肿块患者，需要放疗。在血浆IgA水平较低的情况下发现循环T细胞数量减少，且三分之一患者的血清中存在自身抗体，这可能意味着在眼眶中发生淋巴增殖性病变的个体，无论病变是增生性还是肿瘤性，都存在部分免疫缺陷。
