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Zhang L, Zhang T, Xu G, Zhang C, Qian J, Chang Q, Bi Y, Chen Q. Multipurpose ultrasonographic characteristics of primary uveal MALT lymphoma. Graefes Arch Clin Exp Ophthalmol 2023; 261:2383-2394. [PMID: 36933009 DOI: 10.1007/s00417-022-05958-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 11/29/2022] [Accepted: 12/21/2022] [Indexed: 03/19/2023] Open
Abstract
PURPOSE To investigate the ultrasonographic features in patients with primary uveal mucosa-associated lymphoid tissue (MALT) lymphoma. METHODS Medical records of 12 patients (13 eyes) diagnosed with primary uveal MALT lymphoma between September 2014 and September 2021 were retrospectively reviewed. Ultrasonography, B-scan ultrasonography, color Doppler flow imaging, and ultrasound biomicroscopy findings were retrieved from the medical records. RESULTS Mean age of the included patients was 59.4 ± 8.6 years. Typical ultrasonographic features of the choroidal infiltrates were flat, diffuse, and thickened, with low and homogenous internal reflectivity and with rich arterial blood flow from posterior ciliary arterioles. The mean thickness of the choroidal infiltrates was 1.34 ± 0.68 mm (n = 13). Most of the affected eyes had posterior episcleral extensions, with a mean thickness of 1.66 ± 1.21 mm (n = 12). Typical crescent-like posterior episcleral extensions were detected in nine eyes (69.2%). In six eyes, the blood flow from the choroidal infiltrates communicated with the episcleral extensions. In the ciliary body, the mean thickness of the infiltrates was 1.08 ± 0.43 mm (n = 9), and seven eyes (77.8%) had 360° ring-like infiltrations. The initial best-corrected visual acuity (BCVA) was significantly correlated with the final BCVA after treatment (p < 0.001). CONCLUSION Multipurpose ultrasonographic imaging revealed the unique characteristics of the primary uveal MALT lymphoma and is helpful in the diagnosis of this rare disease.
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Affiliation(s)
- Lili Zhang
- Department of Ophthalmology, Eye, Ear, Nose and Throat Hospital, Shanghai Medical School, Fudan University, Shanghai, 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai Medical School, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, 200031, China
| | - Ting Zhang
- Department of Ophthalmology, Eye, Ear, Nose and Throat Hospital, Shanghai Medical School, Fudan University, Shanghai, 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai Medical School, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, 200031, China
| | - Gezhi Xu
- Department of Ophthalmology, Eye, Ear, Nose and Throat Hospital, Shanghai Medical School, Fudan University, Shanghai, 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai Medical School, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, 200031, China
| | - Chaoran Zhang
- Department of Ophthalmology, Eye, Ear, Nose and Throat Hospital, Shanghai Medical School, Fudan University, Shanghai, 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai Medical School, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, 200031, China
| | - Jiang Qian
- Department of Ophthalmology, Eye, Ear, Nose and Throat Hospital, Shanghai Medical School, Fudan University, Shanghai, 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai Medical School, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, 200031, China
| | - Qing Chang
- Department of Ophthalmology, Eye, Ear, Nose and Throat Hospital, Shanghai Medical School, Fudan University, Shanghai, 200031, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai Medical School, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, 200031, China
| | - Yingwen Bi
- Department of Pathology, Shanghai Medical School, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, 200031, China.
| | - Qian Chen
- Department of Ophthalmology, Eye, Ear, Nose and Throat Hospital, Shanghai Medical School, Fudan University, Shanghai, 200031, China.
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai Medical School, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, 200031, China.
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Freedman K, Shenoy S. Mucosa-associated lymphoid tissue lymphoma with intraocular and orbital involvement: case presentation and review of the literature. Orbit 2017; 37:243-247. [PMID: 29027822 DOI: 10.1080/01676830.2017.1383479] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Primary ocular lymphomas are typically confined to either the eye or the orbit. Rarely, in immune-competent patients, lymphomas affect both the eye and the orbit simultaneously. Mucosa-associated lymphoid tissue (MALT) lymphomas are the most common ocular lymphomas. They usually present primarily in the orbit but sometimes can present primarily in intraocular tissue. MALT lymphomas that occur initially in the uvea can sometimes spread to the adjacent orbit. We report a case of progressively enlarging MALT lymphoma in a 62-year-old immune-competent patient causing a severe mass effect in the orbit and simultaneously presenting with intraocular involvement. There was radiographic evidence of lymphoma confined to the orbit with intraocular involvement. The simultaneous presentation makes it difficult to determine if the lymphoma initially presented in the orbit or intraocular tissue, although the orbital component was more impressive. The case also includes a literature review of simultaneous orbital and intraocular MALT lymphomas. The patient responded to systemic chemotherapy with regression in size of the lymphoma, relief of the mass effect seen in the orbit, and the regression of the intraocular involvement.
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Affiliation(s)
- Kenn Freedman
- a Division of Neuro-Ophthalmology and Oculoplastics , Texas Tech University Health Sciences Center , Lubbock , Texas , USA
| | - Sudhir Shenoy
- b PGY 4, Ophthalmology Resident , Texas Tech University Health Sciences Center , Lubbock , Texas , USA
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Dirani A, Allaire G, Callejo S, Belair ML, Biernacki K, Corriveau C, Hammamji K. Choroidal extranodal marginal zone lymphoma diagnosed by full-thickness retinochoroidal biopsy: case report and review of the literature. Int Med Case Rep J 2017; 10:153-158. [PMID: 28496372 PMCID: PMC5422570 DOI: 10.2147/imcrj.s129171] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The case of an 89-year-old man who was referred for a painless decrease of vision in his right eye (RE) is reported. Fundus examination of the RE showed an elevated amelanotic lesion located in the posterior pole with an adjacent focal round pigmented lesion. There was also a more peripheral amelanotic lesion extending from 6 to 9 o’clock clockwise inferotemporally. Uveitis workup and imaging studies of brain and orbits were normal. A retinochoroidal biopsy was done and showed the presence of choroidal extranodal marginal zone lymphoma. The patient was treated with external beam radiotherapy. This report presents a review of the literature of all reported cases of choroidal extranodal marginal zone lymphoma.
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Affiliation(s)
- Ali Dirani
- Department of Ophthalmology, University of Montreal.,Department of Ophthalmology, University of Montreal Health Center (CHUM)
| | - Guy Allaire
- Department of Pathology, University of Montreal.,Department of Pathology, University of Montreal Health Center (CHUM), Montreal, Canada
| | - Sonia Callejo
- Department of Ophthalmology, University of Montreal.,Department of Ophthalmology, University of Montreal Health Center (CHUM)
| | - Marie Lyne Belair
- Department of Ophthalmology, University of Montreal.,Department of Ophthalmology, University of Montreal Health Center (CHUM)
| | - Katarzyna Biernacki
- Department of Ophthalmology, University of Montreal.,Department of Ophthalmology, University of Montreal Health Center (CHUM)
| | - Christine Corriveau
- Department of Ophthalmology, University of Montreal.,Department of Ophthalmology, University of Montreal Health Center (CHUM)
| | - Karim Hammamji
- Department of Ophthalmology, University of Montreal.,Department of Ophthalmology, University of Montreal Health Center (CHUM)
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Gao X, Li B, You Q, Peng X. Primary extranodal marginal zone B-cell lymphoma with diffuse uveal involvement and focal infiltration of the trabecular meshwork: a case report and review of literature. BMC Ophthalmol 2015; 15:48. [PMID: 25947067 PMCID: PMC4494801 DOI: 10.1186/s12886-015-0038-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 04/29/2015] [Indexed: 12/21/2022] Open
Abstract
Background Primary extranodal marginal zone lymphoma (EMZL) of the uvea is a rare condition and diagnosis may be challenging. We aim to report the clinical, histopathologic and immunohistochemical findings in a case of primary EMZL with diffuse uveal involvement and focal infiltration of the trabecular meshwork. Case presentation A 38-year-old male presented with 2-year progressive vision loss in the right eye. Fundus examination showed choroidal thickening with diffuse retinal pigment epithelium (RPE) changes and inferior exudative retinal detachment. Ultrasonography revealed low-reflective masses with diffuse thickening of the choroid involving the optic nerve and orbit. Despite treatment with steroids, his symptoms progressed over time. One year later, visual acuity of the right eye markedly decreased to no light perception and enucleation was performed. Histopathological findings revealed infiltrates of malignant cells in the choroid, iris, ciliary body and trabecular meshwork. Immunohistochemistry confirmed the diagnosis of primary uveal EMZL. Conclusions This is the first case reporting primary EMZL diffusely involving the uvea with focal infiltration of the trabecular meshwork.
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Affiliation(s)
- Xinxiao Gao
- Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, 17 Hougou Lane, Chongnei Street, Beijing, 100005, China. .,Department of Ophthalmology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
| | - Bin Li
- Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, 17 Hougou Lane, Chongnei Street, Beijing, 100005, China.
| | - Qisheng You
- Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, 17 Hougou Lane, Chongnei Street, Beijing, 100005, China.
| | - Xiaoyan Peng
- Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, 17 Hougou Lane, Chongnei Street, Beijing, 100005, China.
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Loriaut P, Charlotte F, Bodaghi B, Decaudin D, Leblond V, Fardeau C, Desjardins L, Lehoang P, Cassoux N. Choroidal and adnexal extranodal marginal zone B-cell lymphoma: presentation, imaging findings, and therapeutic management in a series of nine cases. Eye (Lond) 2013; 27:828-35. [PMID: 23598677 DOI: 10.1038/eye.2013.74] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Accepted: 03/07/2013] [Indexed: 12/11/2022] Open
Abstract
PURPOSE To describe the clinical and imaging presentation, pitfalls in the diagnosis of choroidal extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT), as well as the therapeutic management and prognosis. METHODS A retrospective case review of nine choroidal MALT lymphomas was performed. Initial clinical presentation and imaging findings of these histologically confirmed cases of lymphoma were analyzed. Treatment methods, time to diagnosis, systemic work-up, and treatment prognosis were assessed. RESULTS Initial presentation was essentially blurred vision. The features described on examination were: anterior and posterior scleritis, iridocyclitis, choroidal infiltration, and exudative retinal detachment. Fluorescein and indocyanine green angiography as well as ultrasonography and optic coherence tomography provided arguments in favor of the diagnosis. Biopsy sites included conjunctiva, Tenon's capsule, deep scleral tissue, episclera, lacrimal gland, and choroid. Treatment mostly consisted of a combination of chemotherapy and radiotherapy. The mean time to diagnosis was 12 months. CONCLUSIONS Owing to the insidious onset of these tumors and their ability to simulate other conditions, the diagnosis is commonly delayed. The prognosis is generally good and treatment is effective in the case of localized lymphoma.
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