J Korean Ophthalmol Soc.  2013 Jul;54(7):1109-1113. 10.3341/jkos.2013.54.7.1109.

Primary Orbital MALT Lymphoma Associated with Localized Amyloidosis

• Lyu IJ
• Woo KI
• Kim YD

• KMID: 2217424
• DOI: http://doi.org/10.3341/jkos.2013.54.7.1109

Abstract

PURPOSE
To report a case of primary orbital MALT lymphoma with localized amyloidosis.
CASE SUMMARY
A 61-year-old male visited our clinic with diplopia, which had developed approximately 5 months earlier. Magnetic resonance imaging of the orbit showed an ill-defined well-enhanced mass in the left inferior orbit. Incisional biopsy of the orbital mass was performed. Histopathological examination revealed diffuse deposits of an amorphous, eosinophilic substance in the extracellular matrix and vessels with lymphocytes infiltration. Lymphocytes were positive for the immunohistochemical stain against the CD20 and kappa-light chain antigens. The amorphous material stained positive for kappa-light chain antigen, and Congo red staining showed birefringence.
CONCLUSIONS
We report a rare case of primary orbital MALT lymphoma associated with localized amyloidosis.

Keyword

Amyloidosis; MALT lymphoma

MeSH Terms

Amyloidosis
Biopsy
Congo Red
Diplopia
Eosinophils
Extracellular Matrix
Humans
Lymphocytes
Lymphoma, B-Cell, Marginal Zone
Magnetic Resonance Imaging
Male
Orbit
Congo Red

Figure

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  Figure 1. Clinical photograph showing proptosis of the left eye.

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  Figure 2. (A) T1-weighted precontrast axial image demonstrating an ill-defined mass in the left orbit isointense to extraocular muscle. (B) T2-weighted precontrast coronal image showing a mass with subtle high signal intensity in the left inferior orbit. (C) T1-weighted postcontrast image demonstrates a well-enhancing soft tissue mass.

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  Figure 3. Axial nonenhanced CT scan reveals left inferior or-bital soft tissue mass with calcifications.

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  Figure 4. (A) Histopathologic examination reveals diffuse deposits of an amorphous, eosinophilic substance in the extracellular ma-trix and vessels with lymphocytes infiltration (hematoxylin and eosin, ×200). (B) High-power magnification shows that the cells are predominantly small lymphocytes (hematoxylin and eosin, ×400). (C) Lymphocytes stain positive for the immunohistochemical stain against the CD20 antigen (×400). (D) Lymphocytes and an amorphous material stain positive for the immunohistochemical stain against κ-light chain antigen (×100). (E) The amorphous material stains positive with Congo red and F, demonstrates ap-ple-green birefringence under the polarized light (Congo red, ×100).

Reference

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