J Korean Ophthalmol Soc.  2015 Jun;56(6):815-822. 10.3341/jkos.2015.56.6.815.

Comparison of Ocular Adnexal Mantle Cell Lymphoma and MALT Lymphoma

• Lee JJ
• Kim MS
• Choi HY
• Park KS
• Lee SB

• KMID: 2339144
• DOI: http://doi.org/10.3341/jkos.2015.56.6.815

Abstract

PURPOSE
Mantle cell lymphoma (MCL) is known to have systemic dissemination with poor prognosis, but very few cases have been reported in Korea. Therefore, we analyzed clinical features and prognosis of MCL by comparing 3 cases of ocular adnexal MCL and mucosa-associated lymphoid tissue (MALT) lymphoma.
METHODS
The medical records of patients with ocular adnexal MALT lymphoma and MCL from Chungnam National University Hospital and Pusan National University Hospital from January 1999 to April 2014 were retrospectively reviewed. Immunohistochemical examination was selectively used to diagnose lymphoma subtypes. Systemic dissemination, treatment response, and recurrence were identified using radiological testing and bone marrow aspiration.
RESULTS
This study included 39 patients with ocular and ocular adnexal MALT lymphoma and 1 patient with MCL from Chungnam National University Hospital and 53 patients with MALT lymphoma and 2 patients with MCL from Pusan National University Hospital. All 3 (100%) patients diagnosed with ocular adnexal MCL were over 60 years of age. However, 28 of 92 (30.4%) patients diagnosed with MALT lymphoma were over 60 years of age. In MALT lymphoma, 3 of 92 patients presented with systemic dissemination and most patients recovered with radiotherapy. Conversely, all 3 patients with MCL showed systemic dissemination and recurrence after radiotherapy or chemotherapy, therefore, additional chemotherapy was required.
CONCLUSIONS
Contrary to MALT lymphoma, ocular and ocular adnexal MCL usually presented with systemic dissemination and complete remission was difficult even though many regimens of chemotherapy were attempted. Because MCL can be misdiagnosed as MALT lymphoma, careful evaluation should be performed.

Keyword

MALT lymphoma; Mantle cell lymphoma; Ocular adnexal lymphoma

MeSH Terms

Bone Marrow
Busan
Chungcheongnam-do
Drug Therapy
Humans
Korea
Lymphoid Tissue
Lymphoma
Lymphoma, B-Cell, Marginal Zone*
Lymphoma, Mantle-Cell*
Medical Records
Prognosis
Radiotherapy
Recurrence
Retrospective Studies

Figure

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  Figure 1. The photograph shows the both lower palpebral conjunctival mass.

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  Figure 2. High-power photomicrograph shows a monotonous proliferation of small to medium sized lymphocyte with irreg-ular, hyperchromatic nuclei, and scant cytoplasm. There are hyalinized vessels in the background (H&E; ×400).

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  Figure 3. Immunohistochemistry showing positive nuclear staining for CD20 (A), cyclin D1 (B), bcl-2 (C), and negative nuclear staining for CD5 (D), respectively.

Reference

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