engleski

Utility of immunohistochemical analysis in the evaluation of ocular adnexal lymphomas

The aim of this study was to classify ocular lymphomas according to the new WHO classification and to determine immunohistochemical markers with prognostic significance. Histopathologic slides of the 24 patients were reviewed and tumors were classified according to the new WHO classification. Average age of patients was 62 years, with 2:1 female predominance. Additional immunohistochemical studies were performed on 35 specimens that were available. The antibodies used were CD3, CD5, CD10, CD20, CD43 and bcl-6. Ocular adnexal lymphoma was found in orbit in 20 patients, in eyelid in 2 and in conjunctiva in 2 patients. Three patients had prior or concurrent systemic disease and 21 patients had primary lymphoma (83.3% Stage IE, 4.2% Stage IIE, 12.5% Stage IV). The main subtypes of non-Hodgkin lymphoma according to the WHO classification were extranodal marginal zone B-cell lymphoma (B-EMZL, 83.3%), diffuse large cell B-cell lymphoma (8.3%), mantle cell lymphoma (4.2%) and plasmocytoma (4.2%).Immunohistochemical marker CD43 was the only parameter of prognostic significance (p=0.035). Pa tients with B-EMZL had almost 14 times higher chance for an unfavorable outcome if the tumor cells expressed CD43 on their surface as compared with the CD43 negative cases. Most ocular adnexal lymphomas usually have a B cell immunophenotype, the morphologic and immunohistochemical features of extranodal marginal zone B-cell lymphoma and a favorable prognosis. Our data suggest that CD43 could be useful to separate the group of patients with B-EMZL with unfavorable prognosis from those that have a good prognosis. CD43 positive ocular lymphomas are associated with a higher rate of subsequent distant recurrence and the rate of lymphoma-related death (p=0.035).

ocular; adnexal; lymphomas

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