Clinical features and recurrence causes of ocular adnexal mucosa-associated lymphoid tissue lymphoma

Abstract

Objective To improve our understanding of the characteristics of ocular adnexal mucosa-associated lymphoid tissue (MALT) lymphoma so as to lower the rate of misdiagnosis,missed diagnosis and recurrence,as well as to improve the survival rate of patients.Methods The clinical features,imaging features,therapy and recurrence of 79 patients with biopsy-proven ocular adnexal MALT lymphoma at Shanghai Changzheng hospital between 1997 and 2010 were retrospectively reviewed.Results Of the 79 cases,there were 49 patients in orbit,14 in conjunctiva,10 in lacrimal gland and 6 in eyelid.The MALT lymphomas occurring in the orbit usually present irregular growth wrapping the eye ring without obvious boundaries.The prevalent clinical manifestations included exophthalmos,restricted eye movement,eyelid edema and the like,while the MALT lymphomas arising in the conjunctiva usually located in conjunctival fomix,characterized by conjunctival congestion and bumps of salmon-like appearance.Treatments of these cases mainly included surgery and radiation therapy.The patients receiving all and part surgical removal was 58 and 21 cases,respectively.All the patients received partial radiotherapy on the eyes after surgery.Recurrence patients were 15 cases after radiation therapy at six months.Bilateral onset (P =0.0143) and the initial reaction to radiotherapy (P＜0.0001) were found to be correlated with the recurrence of ocular adnexal MALT lymphoma.Nonetheless,gender,age,locations,tumor size and surgical procedures had no effects on the recurrence.Conclusions The MALT lymphomas occurring in the orbit usually present irregular growth wrapping the eye ring and without obvious boundaries.Bilateral onset and the initial reaction to radiotherapy are correlated with the recurrence of ocular adnexal MALT lymphoma.Nonetheless surgical procedures have no effects on the recurrence.However,selecting a suitable operation can reduce the incidence of postoperative complications. Key words: Ocular adnexa; Mucosa-associated lymphoid tissue (MALT); Lymphoma; Clinical character; Recurrence