Mantle cell lymphoma in the ocular adnexal region.

Abstract

PURPOSE:

To study the clinicopathologic features of mantle cell lymphoma (MCL) in the ocular adnexal region.

DESIGN:

Retrospective review.

METHODS:

The slides of 23 suspect patients were reevaluated with a panel of monoclonal antibodies, including anti-CD20, cyclin-D1, CD5, CD3, and p53 immunostains. Patients confirmed to have MCL were examined retrospectively on the basis of chart review.

RESULTS:

Ten patients with periocular MCL were included in the study on the basis of characteristic histopathologic features and coexpression of nuclear cyclin-D1. This included 1 female and 9 male patients, with an age range of 32 to 84 years (median, 73.5 years). Median follow-up was 20 months (range, 5-172 months). Six of the 10 patients died, all of lymphoma. The orbit (90%) was most commonly involved followed by the lacrimal gland (50%) and lid (50%), with 90% of cases having lymphoma present at 2 or more periocular sites. Most had a primary periocular presentation (80%) that was associated with stage III/IV disease (80%), including atypical cells in the peripheral blood smear (60%) and bone marrow involvement (70%) at presentation. Three cases were CD5-negative, and 2 other cases showed composite histologic findings (MCL and follicular lymphoma and MCL and a plasma cell neoplasm). Fluorescent in situ hybridization performed in these 2 cases demonstrated t(11;14) in the MCL component. Actuarial survivals were median progression-free (PFS) survival, 12 months; median overall survival (OS), 57 months; 5-year PFS, 0; 5-year OS, 39%.

CONCLUSIONS:

Mantle cell lymphoma presenting in the ocular adnexal region has a male predominance and tends to affect an elderly age group, as is typical of MCL involving nodal sites. A higher frequency of these tumors fail to co-express CD5, and composite lymphomas were observed in 20% of patients. Mantle cell lymphoma presenting in the ocular adnexal region is associated with advanced-stage disease and short PFS but an OS similar to MCL at other sites.

• Authors: Audrey Looi, Randy D Gascoyne, Mukesh Chhanabhai, Joseph M Connors, Jack Rootman, Valerie A White
• Journal: Ophthalmology (Ophthalmology) Vol. 112 Issue 1 Pg. 114-9 (Jan 2005) ISSN: 1549-4713 [Electronic] United States
• PMID: 15629830 (Publication Type: Journal Article)

Chemical References

• Antigens, CD
• Biomarkers, Tumor
• Tumor Suppressor Protein p53
• Cyclin D1

Topics

• Adult
• Aged
• Aged, 80 and over
• Antigens, CD (metabolism)
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Biomarkers, Tumor (metabolism)
• Combined Modality Therapy
• Cyclin D1 (metabolism)
• Eye Neoplasms (metabolism, pathology, therapy)
• Eyelid Neoplasms (metabolism, pathology, therapy)
• Female
• Follow-Up Studies
• Humans
• Immunohistochemistry
• Lacrimal Apparatus Diseases (metabolism, pathology, therapy)
• Lymphoma, Mantle-Cell (metabolism, pathology, therapy)
• Male
• Middle Aged
• Orbital Neoplasms (metabolism, pathology, therapy)
• Retrospective Studies
• Survival Rate
• Tumor Suppressor Protein p53 (metabolism)