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Kim JH, Jeon YW, Choi BO, Park G, Hong YK, Yang SW, Cho SG. Intracranial relapse as a solitary mass of ocular adnexal lymphoma of the mucosa-associated lymphoid tissue type. Korean J Intern Med 2018; 33:224-227. [PMID: 27599769 PMCID: PMC5768529 DOI: 10.3904/kjim.2015.138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 08/31/2015] [Accepted: 09/13/2015] [Indexed: 11/27/2022] Open
Affiliation(s)
- Jung-Ho Kim
- Division of Hematology and Oncology, Department of Internal Medicine, The Armed Forces Capital Hospital, Seongnam, Korea
| | - Young-Woo Jeon
- Department of Hematology, Catholic Blood and Marrow Transplantation Center, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
| | - Byung-Ock Choi
- Department of Radiation Oncology, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
| | - Gyeongsin Park
- Department of Pathology, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
| | - Yong-Kil Hong
- Department of Neurosurgery, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
| | - Suk-Woo Yang
- Department of Ophthalmology, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
| | - Seok-Goo Cho
- Department of Hematology, Catholic Blood and Marrow Transplantation Center, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
- Correspondence to Seok-Goo Cho, M.D. Department of Hematology, Catholic Blood and Marrow Transplantation Center, College of Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea Tel: +82-2-2258-6052 Fax: +82-2-599-3589 E-mail:
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Zhang Q, Pocrnich C, Kurian A, Hahn AF, Howlett C, Shepherd J, Rizkalla K. Amyloid deposition in extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue: A clinicopathologic study of 5 cases. Pathol Res Pract 2016; 212:185-9. [DOI: 10.1016/j.prp.2015.08.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 06/11/2015] [Accepted: 08/12/2015] [Indexed: 11/25/2022]
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Holds J, Buchanan A, Hanson R. Intralesional interferon-α for the treatment of bilateral conjunctival mucosa-associated lymphoid tissue lymphoma. Pediatr Blood Cancer 2012; 59:176-8. [PMID: 21793177 DOI: 10.1002/pbc.23224] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2011] [Accepted: 05/16/2011] [Indexed: 11/09/2022]
Abstract
We describe a case of bilateral conjunctival mucosa-associated lymphoid tissue (MALT) lymphoma in a 14-year-old female treated with intralesional interferon-α. Interferon-α-2b was injected three times a week for 6 weeks, then once weekly for 12 weeks. Marked tumor reduction was observed by week 5 of treatment, with complete resolution by week 8. There was no sign of recurrence through 27 months of follow-up. Intralesional interferon-α was an effective treatment for this unusual case of conjunctival MALT lymphoma in a very young female. It presents an attractive alternative to traditional treatment modalities in this patient population.
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Affiliation(s)
- John Holds
- Department of Ophthalmology, Saint Louis University, St. Louis, Missouri, USA
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Shetty RK, Adams BH, Tun HW, Runyan BR, Menke DM, Broderick DF. Use of rituximab for periocular and intraocular mucosa-associated lymphoid tissue lymphoma. Ocul Immunol Inflamm 2010; 18:110-2. [PMID: 20370339 DOI: 10.3109/09273940903450313] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The clinical efficacy of rituximab therapy in systemic mucosa-associated lymphoid tissue (MALT) lymphoma with both periocular and intraocular involvement is described. Ophthalmic examination and radiologic imaging demonstrated tumor with bilateral periorbital, lacrimal, and subconjunctival infiltration, a pseudohypopyon in one eye, and extensive systemic lymph node involvement. Lymph node biopsy confirmed the pathologic findings of a low-grade MALT lymphoma. The patient had a complete remission within 3 months of starting rituximab therapy. A recurrence 6 months later remitted with a second round of rituximab therapy and the patient remained tumor-free at 1 year.
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Toquero L, Aboumarzouk OM, Lanzon-Miller S. Colonic MALToma: a case report and review of the literature. BMJ Case Rep 2009; 2009:bcr01.2009.1537. [PMID: 21686997 PMCID: PMC3027871 DOI: 10.1136/bcr.01.2009.1537] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Gastric mucosa associated lymphoid tissue lymphomas (MALTomas) are well-documented and their management effectively established, but colonic MALTomas are extremely rare and not many know it could occur. We report the first colonic MALToma in the UK. The patient was managed in accordance with gastric MALToma management modalities in accordance with the evidence in the literature. After failure of medical management, a surgical resection was the last and successful option for treatment.Though gastric MALToma management is well-established, the colonic form of the disease does not act the same and requires a more aggressive approach.
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Affiliation(s)
- Lawrence Toquero
- Northern General Hospital, General Surgery, Herries Road, Sheffield, S5 7AU, UK
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Topalkara A, Ben-Arie-Weintrob Y, Ferry JA, Foster CS. Conjunctival marginal zone B-cell lymphoma (MALT lymphoma) with amyloid and relapse in the stomach. Ocul Immunol Inflamm 2007; 15:347-50. [PMID: 17763134 DOI: 10.1080/09273940701375410] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The authors report a localized (primary) conjunctival marginal zone B-cell lymphoma (mucosa-associated lymphoid tissue (MALT)-type), with amyloid deposition with relapse in the stomach, 14 months after the initial diagnosis. Ocular adnexal marginal zone B-cell MALT lymphoma is often localized at diagnosis; some relapse in typical MALT sites. There are few reports of localized conjunctival lymphoma with a relapse in the stomach. The authors suggest that all patients with localized ocular adnexal lymphoma be followed for an extended period.
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Affiliation(s)
- A Topalkara
- Massachusetts Eye Research & Surgery Institute and The Ocular Immunology & Uveitis Foundation, Harvard Medical School, Cambridge, MA 02142, USA
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Monzen Y, Hasebe H. Radiotherapy for localized orbital mucosa-associated lymphoid tissue lymphoma. Ophthalmologica 2007; 221:233-7. [PMID: 17579288 DOI: 10.1159/000101924] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2006] [Accepted: 09/22/2006] [Indexed: 11/19/2022]
Abstract
Fourteen patients with localized orbital mucosa-associated lymphoid tissue lymphoma diagnosed between 1998 and 2005 were reviewed. Five patients were males and 9 were females, with a mean age of 58 years. In 8 patients, the disease arose from the conjunctiva, and in 6 patients, it originated from the retrobulbar space. Patients were treated with radiotherapy alone at a dose range from 30 to 54 Gy. All patients with conjunctival lymphoma achieved complete remission (CR). Four patients with retrobulbar lymphoma obtained CR, and unconfirmed CR (CRu) was observed in 2 cases. Orbital extraconal lymphoma disappeared. However, intraconal cord-like tumor and mass involving the medial extraocular muscle remained with the absence of regrowth over the long term. There have been very few reports discussing the histology of residual mass after radiotherapy. Residual mass was suggested to be reactive lymphoid hyperplasia. As a dose of more than 40 Gy induced dry eye syndrome or cataract, the dose must not exceed 40 Gy in order to achieve safe treatment of orbital mucosa-associated lymphoid tissue lymphoma.
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Affiliation(s)
- Yoshio Monzen
- Department of Radiology, Hiroshima Prefectural Hospital, 1-5-54 Ujinakanda Minami-ku, Hiroshima 734-8530, Japan.
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Sarraf D, Jain A, Dubovy S, Kreiger A, Fong D, Paschal J. Mucosa-associated lymphoid tissue lymphoma with intraocular involvement. Retina 2005; 25:94-8. [PMID: 15655452 DOI: 10.1097/00006982-200501000-00018] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To report the clinicopathologic features of a patient with mucosa-associated lymphoid tissue (MALT) lymphoma of the conjunctiva and associated intraocular involvement. METHODS This study is a retrospective clinicopathologic correlative case report summarizing the clinical, radiologic, and histopathologic findings of a patient with conjunctival MALT lymphoma and associated intraocular involvement. RESULTS Ophthalmic examination and fluorescein angiography demonstrated progressive conjunctival infiltration bilaterally, marked uveal effusions in the left eye, and cellular white infiltrates of the choroid in the right eye. MRI of the orbit revealed a diffusely infiltrating intra- and extraocular lesion extending around the globe and optic nerve in the left eye without evidence of intracranial extension. Conjunctival biopsy showed low-grade tumor cells, consistent with the diagnosis of MALT lymphoma. The patient was successfully treated with external beam radiation with marked clinical improvement. CONCLUSION Conjunctival MALT lymphomas, typically indolent and localized tumors, may extend into the orbit and invade local tissues such as the choroid with devastating consequences. A conjunctival biopsy can provide an easy diagnosis of this treatable entity.
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Affiliation(s)
- David Sarraf
- Jules Stein Eye Institute, UCLA School of Medicine, Los Angeles, CA 90095, USA.
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Lucas RS, Mortimore R, Sullivan TJ, Waldie M. Interferon treatment of childhood conjunctival lymphoma. Br J Ophthalmol 2003; 87:1191. [PMID: 12928301 PMCID: PMC1771832 DOI: 10.1136/bjo.87.9.1191] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Cho EY, Han JJ, Ree HJ, Ko YH, Kang YK, Ahn HS, Ahn SD, Park CJ, Huh J. Clinicopathologic analysis of ocular adnexal lymphomas: extranodal marginal zone b-cell lymphoma constitutes the vast majority of ocular lymphomas among Koreans and affects younger patients. Am J Hematol 2003; 73:87-96. [PMID: 12749009 DOI: 10.1002/ajh.10332] [Citation(s) in RCA: 99] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The majority of ocular adnexal lymphomas (OAL) are primary marginal zone B-cell lymphomas (MALT lymphomas). The present study correlated the clinicopathological variables with the histologic subtypes by World Health Organization (WHO) classification with emphasis on MALT lymphomas in OALs of Koreans. There were 68 cases (31 males and 37 females), with a mean age of 45.9 years (range 7-89 years). Histologically, 61 MALT-type, 2 diffuse large B-cell (DLBCL), 2 mantle cell type (MCL), 1 anaplastic large-cell (ALCL), and 2 NK/T-cell lymphomas (NK/T-L) were counted among them. Fifty-seven were primary cases (P-OAL), and 11 were secondary cases (S-OAL). Nearly all P-OALs were MALT lymphomas (n = 56, 98%), with an exception of 1 MCL. Eleven S-OALs included 5 MALT type, 2 DLBCL, 1 ALCL, 1 MCL, and 2 NK/T-L. All MALT lymphoma patients were alive (n = 59) except for 2 after a mean duration of follow-up of 27.6 months (range: 0-108 months): one died of an unrelated cause and one died of recurrence. One non-MALT type P-OAL was alive with no evidence of disease (42 months). Of the 11 S-OAL, 4 had marrow involvement and 5 had progression or relapse outside the orbit. Compared with the other subtypes, MALT lymphoma was more likely to present with local disease (P = 0.001), achieve complete remission (CR) (0.022), and be alive at last follow-up (0.197), and less likely to experience recurrence (P = 0.06). In conclusion, OALs in Koreans are characterized by a preponderance of primary lymphomas over systemic lymphomas, striking predominance of MALT type lymphomas, and young age of occurrence. Histologic subtype by WHO classification has a significant correlation with the final outcome, with the most favorable outcome associated with OALs of the MALT type.
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Affiliation(s)
- Eun Yoon Cho
- Department of Diagnostic Pathology, Asan Medical Center, University of Ulsan-College of Medicine, Seoul, Korea
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Abstract
The conjunctiva forms a continuous mucosal surface from the eyelid margin to the cornea, and makes contact with airborne antigens and those on the adjacent eyelid skin and preocular tear film. Conjunctival lymphoid follicles (CLF) undergo hyperplasia upon conjunctival infection by a specific array of pathogens; infection-associated enlargement of draining preauricular lymph nodes suggests that CLF participate in the afferent limb of acquired immune responses for the ocular surface. In this review, we examine the evidence for classification of CLF as part of the common mucosal immune system, and explore the possible therapeutic implications.
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Affiliation(s)
- James Chodosh
- Molecular Pathogenesis of Eye Infection Research Center, Dean A. McGee Eye Institute, Departments of Ophthalmology and Cell Biology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA.
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Blasi MA, Gherlinzoni F, Calvisi G, Sasso P, Tani M, Cellini M, Balestrazzi E. Local chemotherapy with interferon-alpha for conjunctival mucosa-associated lymphoid tissue lymphoma: a preliminary report. Ophthalmology 2001; 108:559-62. [PMID: 11237911 DOI: 10.1016/s0161-6420(00)00591-1] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To evaluate the efficacy of subconjunctival interferon-alpha for the treatment of conjunctival mucosa-associated lymphoid tissue (MALT) lymphoma. DESIGN Small, noncomparative, interventional case series. PARTICIPANTS Five patients with histologically proven conjunctival MALT lymphoma were studied prospectively. METHODS Patients were given 1,500,000 international units (IU) of interferon-alpha (IFN-alpha) (Roferon-A) subconjunctivally inside the lesion, three times a week for four weeks. If there was even a minimal response, a further cycle of 1,000,000 IU three times a week for four weeks was administered. Patients received a maintenance dose of 1 million IU, every 15 days for 4 times, after clinical resolution of the lesion. MAIN OUTCOME MEASURES Patients were followed clinically, with slit lamp examination, for evidence of tumor disappearance or recurrence. RESULTS Complete response was obtained in all patients. The lesion resolved completely by the eighth week. Four patients did not show any local recurrence with a median follow-up of 21 months (12-36 months). One patient presented with a recurrence after 11 months, in association with systemic lymphoma progression. CONCLUSIONS Local chemotherapy with IFN-alpha seems to be an effective treatment modality, alternative to radiotherapy, for conjunctival MALT lymphomas.
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Affiliation(s)
- M A Blasi
- Department of Ophthalmology, University of L'Aquila, L'Aquila, Italy.
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Schechter NR, Yahalom J. Low-grade MALT lymphoma of the stomach: a review of treatment options. Int J Radiat Oncol Biol Phys 2000; 46:1093-103. [PMID: 10725618 DOI: 10.1016/s0360-3016(99)00522-2] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE Low-grade mucosa-associated lymphoid tissue (MALT) lymphoma of the stomach (MLS) is often associated with the presence of Helicobacter pylori (H. pylori) bacteria. Eradication of the infection with antibiotic therapy may result in regression of the lymphoma. But when antibiotic treatment fails to reverse the malignant process or if H. pylori is absent, other treatment options should be considered. Because MLS is often confined to the stomach and regional lymph nodes, it is potentially curable with local therapy. Endoscopy and improved imaging, with endoscopic ultrasound (EUS) and computerized tomography (CT), have reduced the prior dependence on surgery for diagnosis and staging of gastric lymphomas. METHODS AND RESULTS This review details the advances in the diagnosis, classification, and imaging of MLS. We also describe the experience that supports the use of radiation therapy as the preferred treatment of MLS in patients who have not responded to antibiotic therapy or have not had evidence for H. pylori infection. CONCLUSIONS Radiation therapy for MLS is not only effective and safe, but offers the significant advantage of low morbidity and gastric function preservation.
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Affiliation(s)
- N R Schechter
- Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
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