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Vest SD, Coupland SE, Esmaeli B, Finger PT, Graue GF, Grossniklaus HE, Hindso TG, Holm F, Honavar SG, Khong JJ, Kirkegaard MK, McKelvie PA, Mikkelsen LH, Mulay K, Rasmussen PK, Siersma V, Sjö LD, Sniegowski MC, Thuro BA, Vemuganti GK, Heegaard S. Specific location of ocular adnexal lymphoma and mortality: an international multicentre retrospective study. Br J Ophthalmol 2023; 107:1231-1238. [PMID: 35512851 DOI: 10.1136/bjophthalmol-2021-320466] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 04/14/2022] [Indexed: 11/03/2022]
Abstract
AIMS To examine whether the specific location of ocular adnexal lymphoma (OAL) and the American Joint Committee on Cancer (AJCC) TNM tumour stage are prognostic factors for mortality in the main OAL subtypes. METHODS Clinical and survival data were retrospectively collected from seven international eye cancer centres. All patients from 1980 to 2017 with histologically verified primary or secondary OAL were included. Cox regression was used to compare the ocular adnexal tumour locations on all-cause mortality and disease-specific mortality. RESULTS OAL was identified in 1168 patients. The most frequent lymphoma subtypes were extranodal marginal zone B-cell lymphoma (EMZL) (n=688, 59%); follicular lymphoma (FL) (n=150, 13%); diffuse large B-cell lymphoma (DLBCL) (n=131, 11%); and mantle cell lymphoma (MCL) (n=89, 8%). AJCC/TNM tumour-stage (T-stage) was significantly associated with disease-specific mortality in primary ocular adnexal EMZL and increased through T-categories from T1 to T3 disease. No associations between AJCC/TNM T-stage and mortality were found in primary ocular adnexal FL, DLBCL, or MCL. EMZL located in the eyelid had a significantly increased disease-specific mortality compared with orbital and conjunctival EMZL, in both primary EMZL and the full EMZL cohort. In DLBCL, eyelid location had a significantly higher disease-specific mortality compared with an orbital or lacrimal gland location. CONCLUSION Disease-specific mortality is associated with AJCC/TNM T-stage in primary ocular adnexal EMZL patients. Lymphoma of the eyelid has the highest disease-specific mortality in primary EMZL, and in the full cohort of EMZL and DLBCL patients.
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Affiliation(s)
- Stine Dahl Vest
- Eye Pathology Section, Department of Pathology, Rigshospitalet, Copenhagen, Denmark
- Department of Ophthalmology, Rigshospitalet, Copenhagen, Denmark
| | - Sarah E Coupland
- Department of Cellular and Molecular Pathology, University of Liverpool, Liverpool, UK
| | - Bita Esmaeli
- Orbital Oncology and Ophthalmic Plastic Surgery, Department of Plastic Surgery, University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA
| | - Paul T Finger
- The New York Eye Cancer Center, New York City, New York, USA
| | - Gerardo F Graue
- The New York Eye Cancer Center, New York City, New York, USA
| | - Hans E Grossniklaus
- Section of Ocular Oncology, Emory University Eye Center, Atlanta, Georgia, USA
| | | | - Frederik Holm
- Eye Pathology Section, Department of Pathology, Rigshospitalet, Copenhagen, Denmark
| | - Santosh G Honavar
- Department of Ocular Oncology and Oculoplastics, LV Prasad Eye Institute, Hyderabad, India
- Department of Ophthalmic and Facial Plastic Surgery, Orbit and Ocular Oncology, Centre for Sight, Hyderabad, India
| | - Jwu Jin Khong
- Orbital, Plastic, and Lacrimal Unit, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | | | - Penelope A McKelvie
- Department of Anatomical Pathology, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Lauge Hjorth Mikkelsen
- Eye Pathology Section, Department of Pathology, Rigshospitalet, Copenhagen, Denmark
- Department of Ophthalmology, Rigshospitalet, Copenhagen, Denmark
| | - Kaustubh Mulay
- National Reporting Centre for Ophthalmic Pathology, Centre for Sight, Hyderabad, India
| | | | - Volkert Siersma
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen Faculty of Health Sciences, Copenhagen, Denmark
| | - Lene Dissing Sjö
- Eye Pathology Section, Department of Pathology, Rigshospitalet, Copenhagen, Denmark
| | - Matthew C Sniegowski
- Orbital Oncology and Ophthalmic Plastic Surgery, Department of Plastic Surgery, University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA
| | - Bradley A Thuro
- Orbital Oncology and Ophthalmic Plastic Surgery, Department of Plastic Surgery, University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA
| | - Geeta K Vemuganti
- Kallam Anji Reddy Campus, School of Medical Sciences, University of Hyderabad, Hyderabad, India
- Visiting Faculty, Ophthalmic Pathology Services, LV Prasad Eye Institute, Hyderabad, India
| | - Steffen Heegaard
- Eye Pathology Section, Department of Pathology, Rigshospitalet, Copenhagen, Denmark
- Department of Ophthalmology, Rigshospitalet, Copenhagen, Denmark
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Guo Q, Liu R, Zhang X, Yang B, Ma J. Local recurrence as extraocular muscle lymphoma after 6 years of chronic myositis: a case report. BMC Ophthalmol 2022; 22:403. [PMID: 36209053 PMCID: PMC9548203 DOI: 10.1186/s12886-022-02623-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 09/30/2022] [Indexed: 11/10/2022] Open
Abstract
Background Extraocular muscle is usually affected by thyroid disease or inflammatory pseudotumor, but seldom by neoplastic process. Primary malignant lymphoma involving isolated extraocular muscle is very rare, especially after 6 years of chronic myositis. Case presentation A middle-aged female presented with swelling of the lower lid of the right eye for 2 months. Magnetic resonance imaging showed significant enlargement of the right inferior rectus muscle belly. The patient first presented 6 years prior with upper eyelid swelling. A total of 5 surgical biopsies of the right eye were performed during 6 years with the following successive findings: inflammatory pseudotumor, chronic inflammation, inflammatory lesions, IgG4-related ophthalmic disease, and lastly, extraocular muscle extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma). Conclusion MALT lymphoma may have occurred as a result of chronic extraocular myositis. Malignancy should be considered in patients with recurrent painless extraocular muscle hypertrophy. Differential diagnosis can rule out thyroid-associated ophthalmopathy (TAO), whose symptoms are similar. Diagnosis confirmation by biopsy is warranted if necessary.
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Affiliation(s)
- Qihan Guo
- Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Rui Liu
- Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Xuan Zhang
- Ophthalmology, Taian City Central Hospital, Tai'an, Shandong Province, China
| | - Bentao Yang
- Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jianmin Ma
- Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
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[Treatment and prognosis of primary ocular adnexal extranodal marginal zone mucosa-associated lymphoid tissue lymphoma: a report from a single center]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2022; 43:209-214. [PMID: 35405778 PMCID: PMC9072066 DOI: 10.3760/cma.j.issn.0253-2727.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: This study aimed to see how different initial treatment regimens affected the long-term prognosis of patients with extranodal marginal zone mucosa-associated lymphoid tissue lymphoma confining to the ocular adnexal (OAML) . Methods: Between April 2008 and April 2019, 109 patients with initial mucosa-associated lymphoid tissue confining to ocular adnexal were evaluated and followed-up, and the prognosis of various initial treatment regimens were examined. Results: A total of 36 patients underwent complete surgical resection of the lesions, and 73 patients had residual lesions after surgery, of which 37 patients chose watchful waiting, and 36 patients chose treatment. The treatment regimen included local radiotherapy and systemic treatment (chemotherapy, immunochemotherapy, the combination of radiotherapy and chemotherapy, etc.) , and no serious toxic and side effects were observed in patients receiving systemic treatment. The median follow-up time was 61 (10-142) months. The 5-year and 10-year progression-free survival (PFS) of monocular involvement patients were 78.2% and 76.0% . The 5-year and 10-year PFS rates of patients with binocular involvement were 64.4% and 23.5%. There was significant diference in PFS between patients with monocular and binocular involvement (P=0.010) . Patients who received additional treatment had higher PFS than those patients in the watchful waiting group (P=0.046) . The 5-year PFS was 71.4% and 90.1% among patients in the watchful waiting group and those who received additional treatment, whereas the 10-year PFS was 63.5% and 75.1% , respectively. Patients with OAML were still a risk of disease progression after 5 years. Conclusions: Patients with binocular involvement OAML at the start of the disease had a poor prognosis, but treatment could reduce the risk of recurrence/progression. Systemic therapy is one of the first-line treatment options for patients with OAML, who require long-term monitoring.
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Zschoche M, Zimpfer A, Scheef BO, Jünemann AM, Guthoff RF, Junghanss C, Hildebrandt G, Emmert S, Erbersdobler A, Kundt G, Kakkassery V. Histopathological Features and Ann Arbor Stage in Periocular Lymphoma. In Vivo 2021; 34:1965-1974. [PMID: 32606168 DOI: 10.21873/invivo.11993] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 04/19/2020] [Accepted: 04/22/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND To evaluate biodata, symptoms/signs, lymphoma type, localization, stage level, treatment choice and outcome of ocular adnexal lymphoma (OAL). PATIENTS AND METHODS A single-center retrospective analysis of 56 patients with OAL was performed from 1998 to 2018. RESULTS OAL involved the orbit in 44.6%, the conjunctiva in 32.1%, the lacrimal apparatus in 14.3% and the eyelid in 8.93%. Extranodal marginal zone B-cell lymphoma (EMZL) was found in 60.7%, follicular lymphoma (FL) in 21.4%, diffuse large B-cell lymphoma in 7.14%, mantle cell lymphoma in 5.36% and chronic lymphatic leukaemia in 5.36% patients. No relapse was seen in 76%. EMZL and FL had a significantly better overall survival compared to other lymphoma types (p=0.002). Patients with Ann Arbor stage IE had a significantly better prognosis than those with stages higher than IE (p=0.048). CONCLUSION Our data suggest that clinicopathological features such as Ann Arbor stage influence survival.
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Affiliation(s)
- Marco Zschoche
- Department of Ophthalmology, University Medical Center Rostock, Rostock, Germany
| | - Annette Zimpfer
- Institute of Pathology, University Medical Center Rostock, Rostock, Germany
| | - Björn O Scheef
- Department of Ophthalmology, University Medical Center Rostock, Rostock, Germany
| | - Anselm M Jünemann
- Department of Ophthalmology, University Medical Center Rostock, Rostock, Germany
| | - Rudolf F Guthoff
- Department of Ophthalmology, University Medical Center Rostock, Rostock, Germany
| | | | - Guido Hildebrandt
- Department of Radiotherapy, University Medical Center Rostock, Rostock, Germany
| | - Steffen Emmert
- Clinic and Polyclinic for Dermatology and Venereology, University Medical Center Rostock, Rostock, Germany
| | | | - Günther Kundt
- Institute for Biostatistics and Informatics in Medicine and Ageing Research, University of Rostock, Rostock, Germany
| | - Vinodh Kakkassery
- Department of Ophthalmology, University Medical Center Rostock, Rostock, Germany .,Department of Ophthalmology, University-Hospital Schleswig-Holstein, University of Luebeck, Luebeck, Germany
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Marques MDO, Manso PG, Araujo RLC, Brito FDN, Herculani JEDCC, Lemos GGD, Rodrigues MA, Teixeira LF, Espirito Santo KSD, Menezes YD, Cecyn KZ, Colleoni GWB, Baiocchi OCG. Long-term outcomes of ocular adnexal lymphomas: case series from two lymphoma centers in Brazil. Leuk Lymphoma 2021; 62:1013-1015. [PMID: 33461351 DOI: 10.1080/10428194.2020.1855348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
| | - Paulo Goes Manso
- Ophthalmology Department, Universidade Federal de São Paulo, São Paulo, Brasil
| | - Raphael L C Araujo
- Clinical and Experimental Oncology Department, Universidade Federal de São Paulo, São Paulo, Brasil
| | | | | | | | | | | | | | - Yara de Menezes
- Pathology Department, Hospital Alemão Oswaldo Cruz, São Paulo, Brasil
| | - Karin Zattar Cecyn
- Clinical and Experimental Oncology Department, Universidade Federal de São Paulo, São Paulo, Brasil
| | - Gisele W Braga Colleoni
- Clinical and Experimental Oncology Department, Universidade Federal de São Paulo, São Paulo, Brasil
| | - Otavio C G Baiocchi
- Clinical and Experimental Oncology Department, Universidade Federal de São Paulo, São Paulo, Brasil.,Hematology Department, Hospital Alemão Oswaldo Cruz, São Paulo, Brasil
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Orbital and ocular adnexal lymphoma: a review of epidemiology and prognostic factors in Taiwan. Eye (Lond) 2020; 35:1946-1953. [PMID: 32994547 DOI: 10.1038/s41433-020-01198-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 08/19/2020] [Accepted: 09/18/2020] [Indexed: 12/18/2022] Open
Abstract
PURPOSE To investigate the clinical features, prognostic outcomes of patients with orbital and ocular adnexal lymphoma (OALs) in Taiwanese cohort. METHODS Total 112 patients with OALs were retrospectively reviewed. Demographic information such as age, gender, lymphoma subtype, tumor location and treatment modalities were recorded. The primary endpoints were disease-specific survival (DSS), and progression-free survival (PFS). RESULTS The mean patient age was 59.0 ± 15.5 years (range, 23-92 years). The major histopathologic subtypes were mucosa-associated lymphoid tissue (MALT) lymphoma in 76 patients (67.9%), followed by diffuse large B-cell lymphoma (DLBCL) (9.8%), follicular cell lymphoma (FL) (8.0%), and small lymphocytic lymphoma (SLL) (5.4%). The anatomical locations for OALs were the orbit (44 patients, 39.3%), the conjunctiva (31 patients, 27.7%), the lacrimal gland (28 patients, 25.0%), and the eyelid (8 patients, 7.1%). With a mean follow-up time of 74.5 ± 59.8 months (range 6-342 months), the DSS for all patients were 93.1%, 87.7%, and 68.8% at 60, 120, and 180 months' follow-up, respectively. The PFS at 60, 120, and 180 months' follow-up were 86.2%, 61.2%, and 44.6%, respectively. Regarding the analysis of prognostic factors, patients with high grade lymphoma subtype and advanced stage exhibited a worse prognosis. CONCLUSIONS MALT type lymphoma constitutes most of OALs in Taiwan and occurs more frequently than in Western countries. Patients with MALT lymphoma, FL, SLL and earlier stage have favorable outcomes compared with patients of high grade lymphoma and Ann Arbor stage IV lymphoma.
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