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Clinical characteristics and treatment outcomes of natural killer/T-cell lymphoma involving the ocular adnexa
  1. Ga-In Lee,
  2. Yoon-Duck Kim,
  3. Stephanie Ming Young,
  4. Seonae Shin,
  5. Kyung In Woo
  1. Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
  1. Correspondence to Dr Yoon-Duck Kim, Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea; yoonduck.kim{at}samsung.com

Abstract

Aims To evaluate the clinical characteristics and treatment outcomes of natural killer/T-cell lymphoma (NKTL) involving the ocular adnexa.

Methods Retrospective, comparative, observational case series. A total of 350 patients with NKTL, including 27 patients with NKTL involving the ocular adnexa from 1999 to 2016. The patients were grouped into two groups: group 1 comprised patients presenting with ophthalmic symptoms, and group 2 comprised patients presenting with symptoms from other organs but subsequently developed ophthalmic involvement.

Results Group 1 comprised 12 patients (44.4%) and group 2 comprised 15 (55.6%). Mean duration of symptoms in group 1 was 1.8±1.2 months, while the time from diagnosis of NKTL to development of ophthalmic symptoms in group 2 was 45.3±65.6 months. Periorbital swelling was the most common presenting symptom in both groups (83.3% in group 1 and 73.3% in group 2). Symptoms mimicking cellulitis and pseudotumor were present in 50.0% and 16.7% of cases, respectively. The 5-year overall survival rate was 18.5% in group 1 and 26.4% in group 2, while the 5-year progression-free survival rate was 0% and 13.3%, respectively.

Conclusions Our series is to our knowledge the largest cohort study on NKTL reported to date and demonstrates that ocular adnexal NKTL is a rare but seriously fatal disease. It is characterised by acute inflammatory signs as present in as many as two-thirds of our patients in this series. It should be considered as a differential diagnosis in patients presenting with rapidly progressing proptosis and diagnosed promptly for optimal management.

  • masquerading syndrome
  • natural killer T-cell lymphoma
  • ocular adnexal lymphoma
  • survival analysis

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Footnotes

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Ethics approval Institutional review board approval was obtained, and the study was performed in accordance with the principles of the Declaration of Helsinki.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent Detail has been removed from this case description to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

  • Contributors G-IL, SMY, KIW and Y-DK designed and conducted the study, collecting the data, managed the study, and analysed and interpreted the data. G-IL and SS collected the data. G-IL, SMY and Y-DK contributed to the review and revision of the manuscript. G-IL drafted and revised the manuscript. Y-DK reviewed and approved the final version of the manuscript.

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