The survey of 110 orbital lymphoproliferative lesion according to histopathology and IHC findings

Purpose: The most common type of ocular lymphoma isnon-Hodgkin lymphoma (NHL). Ocular NHL is categorized into two groups: indolent (slow growing) and aggressive (rapid progression). Differentiating benign reactive lymphoid hyperplasia (RLH) from malignant ocularadnexal lymphoma (OAL) is challenging. Histopathology, immunohistochemistry (IHC) and flow cytometryare diagnostic methods that have been applied in this area. Methods: In this retrospective case series, from 2002 to 2013 at Farabi eye center, 110 patients with ocular lymphoproliferative disease were enrolled. Prevalence, anatomical locations, mean age at diagnosis and the final diagnosis of the disease with IHC were assessed. Comparison between previous pathologic diagnoses and results of IHCwas made. Immunoglobulin light chains and B-cell and T-cell markers and other immunophenotyping markers including CD20,CD3,CD5,CD23,CD10, CYCLIND1 and BCL2 were evaluated to determine the most accurate diagnosis.The lymphomas were categorized based on revised European-American lymphoma (REAL) classification. Results: Mean age (years) of the patients was55.56± 19/3, from which 61%wasmale.Patients with follicular lymphoma, large B-cell lymphoma orsmallcell leukemia/lymphoma (SLL) were older than other patients. Nine patients with the previous diagnosis of low grade B-cell lymphoma were re-evaluated by IHC; extranodal marginal zone lymphoma(EMZL) (n=1), small lymphocytic lymphoma SLL(n=1), mantle cell lymphoma (MCL)(n=3),reactive lymphoid hyperplasia RLH (n=2). 2 case were excluded because of poor block quality. Orbit (49.1%), conjunctiva (16.1%) and lacrimal glands (16.1%) were the most common sites of involvement.. Flowcytometry reports in these sevenpatients revealedSLL (n=1) with positive CD5 and CD23, MCL(n=3) with positive CD5 and CyclinD1 and negative CD23, EMZL (n=1) with negative CD5,CD23 and CD10 and RLH (n=2). One RLH patient wasnegative for Kappa/Lambda and positive for CD3 and CD20 and the other was positive for all of the light chains, CD3 and CD20. Conclusion: The reason of importance of accurate classification is the enablement of appropriate therapeutic measures. This will be achieved with precise histologic and IHC analysis by expert pathologists. .

کلیدواژه ها:

ocular adnexal lymphoma ، immunohistochemistry