Clinical pathological reviewsOcular Adnexal Lymphomas: Five Case Presentations and a Review of the Literature
Section snippets
Case Histories
A summary of the relevant clinical information is presented in Table 1.
Tissue samples
The five cases were collected from the consultation files of the Reference Center for Hematopathology, Pathology Department of University Hospital Benjamin Franklin, Berlin, Germany. All tissue biopsies had been fixed in 4% buffered formalin and embedded in paraffin. Conventional histological stains included hematoxylin and eosin, Giemsa, and periodic-acid Schiff (PAS).
Immunohistology
Additional slides were stained with several monoclonal and polyclonal antibodies that are reactive in paraffin sections for
Results
The results of the immunohistochemical, in-situ hybridization and molecular biological findings of the cases examined are summarized in Table 2.
Discussion
The lymphomas of the ocular adnexa are almost exclusively extranodal B-cell non-Hodgkin lymphoma.3, 12, 35, 44, 55, 61, 82 They delineate one end of the spectrum of lymphoproliferative lesions which occur in these tissues; the other pole being represented by reactive lymphoid hyperplasia. A group of tumors, termed atypical lymphoid hyperplasia, exists between the two ends of this spectrum: these are lymphoproliferative lesions, which cannot be placed unequivocally in either of the two major
Summary
Lymphoproliferative disease of the ocular adnexa includes a spectrum of lesions that can present with similar clinical and radiological features. They represented considerable diagnostic dilemmas for both the clinician and pathologist in the past; however, by employing morphological, immunohistochemical, and molecular biological criteria, the ocular adnexal lymphoid lesions can be better distinguished today into reactive lymphoid hyperplasia, atypical lymphoid hyperplasia, and malignant
Method of Literature Search
Literature selection for this article was based on a Medline search spanning the period 1966 to September 2001 for all articles using the following keywords, singularly and in various combinations: ocular adnexa, orbit, conjunctiva, lymphoma, lymphoproliferative lesion, eye, extranodal marginal zone B-cell lymphoma, “mucosa-associated lymphatic tissue” lymphoma, Burkitt lymphoma, Hodgkin's disease, treatment, prognosis, REAL Classification. The German, French, and Japanese articles were
Acknowledgements
The authors would sincerely like to thank the clinical ophthalmologists (particularly Professor M. H. Foerster) and oncologists involved in the treatment of the above five patients for the provision of clinical files, the confidence of which has been strictly maintained. Furthermore, the authors would like to thank Mr. H-H. Müller for his supportive technical assistance. The authors reported no proprietary or commercial interest in any product mentioned or concept discussed in this article.
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