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Prevalence of a Histologic Change of Ocular Adnexal Lymphoma in Patients With a History of Lymphoma

Sagiv, Oded, M.D.*; Thakar, Sudip D., M.D.*; Manning, John T., M.D.; Kandl, Thomas J., M.D.*; Fayad, Luis E., M.D.; Fowler, Nathan, M.D.; Hagemeister, Fredrick B., M.D.; Fanale, Michelle A., M.D.; Pinnix, Chelsea C., M.D., Ph.D.§; Samaniego, Felipe, M.D.; Esmaeli, Bita, M.D.*

Ophthalmic Plastic & Reconstructive Surgery: May/June 2019 - Volume 35 - Issue 3 - p 243–246
doi: 10.1097/IOP.0000000000001215
Original Investigations
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Purpose: The authors examined the prevalence of a histologic change of ocular adnexal lymphoma (OAL) grade in patients with a history of lymphoma in nonocular sites.

Methods: In this retrospective study, the authors reviewed the clinical and pathological data of 209 patients with OAL treated by the senior author during 2000 to 2017.

Results: Of 209 patients with OAL, 65 (31%) had a history of lymphoma. In 54 of the 65 patients (83%), the original lymphoma and OAL were of the same histologic type. In 8 of the 65 patients (12.3%), the OAL was more indolent than the original lymphoma: 6 patients with a history of diffuse large B-cell lymphoma, one of mantle cell lymphoma, and one of grade 3 follicular lymphoma had biopsy-proven extranodal marginal-zone lymphoma in the orbital area. Two additional patients (3%) with a history of chronic lymphocytic leukemia developed OAL: diffuse large B-cell lymphoma in one patient and extranodal marginal-zone lymphoma in the other. One patient (1.5%) with a history of a low-grade follicular lymphoma relapsed as a different low-grade histology of extranodal marginal-zone lymphoma. Lower-grade OAL than the original lymphoma was more common than higher-grade OAL than the original lymphoma (p = 0.048).

Conclusions: In this cohort of 209 patients with OAL, the authors found that nearly one third had a history of lymphoma, 17% of whom had a different histologic type of lymphoma in the orbit, more commonly a more indolent type. This underscores the importance of biopsy of OAL even in patients with a known history of lymphoma to determine the histologic subtype of orbital lymphoma and to help guide appropriate treatment.

Among 65 patients with ocular adnexal lymphoma and a history of lymphoma, 8 patients (12%) had an ocular adnexal lymphoma of more indolent type (downgraded lymphoma) than the original lymphoma.

*Orbital Oncology and Ophthalmic Plastic Surgery, Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A.

Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A.

Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A.

§Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A.

Accepted for publication July 10, 2018.

The authors have no financial or conflicts of interest to disclose.

Address correspondence and reprint requests to Bita Esmaeli, M.D., Orbital Oncology and Ophthalmic Plastic Surgery, Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1488, Houston, TX 77030. E-mail: besmaeli@mdanderson.org

© 2019 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.