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J.J. Miller, S.R. Dubovy, M. Nassiri, G. Byrne, D. Tse, T. Johnson, A. Neff; Peripheral Blood Involvement in Orbital Lymphoproliferative Lesions . Invest. Ophthalmol. Vis. Sci. 2003;44(13):2228.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: The purpose of this study is to summarize the characteristics of circulating lymphoid cells in patients with ocular adnexal lymphoproliferative lesions and to determine if peripheral blood flow cytometry provides information important to patient treatment decisions. Methods: From 1989 to 2000, 221 cases of suspected ocular adnexal lymphoproliferative lesions presenting to the Bascom Palmer Eye Institute were identified. 22 of 221 cases had peripheral blood flow cytometry performed during oncology workup. Tissue samples were evaluated for morphology, immunophenotype (immunohistochemistry or flow cytometry), and molecular biology (Southern blot or PCR). Retrospective chart review for clinicopathologic correlation was performed. Results: Of the 22 ocular adnexal lymphoproliferative disease patients who had peripheral blood flow cytometry performed, 18 had lesions located within the orbit and 4 had lesions located in the conjunctiva. 14 were classified as extranodal marginal zone lymphoma, 6 were classified as small lymphocytic category, one was classified as a plasmacytoma, and one was classified as lymphoid hyperplasia. Peripheral blood flow cytometry of those with extranodal marginal zone lymphoma revealed 2 clonal, 3 atypical, and 9 heterogenous (normal) circulating lymphoid populations. Peripheral blood flow cytometry on the other subtypes of lymphoproliferative disease revealed heterogenous circulating lymphocytes. The two cases with circulating monoclonal B cells both originated from extranodal marginal zone lymphomas. Both had successful clinical outcomes at mean 16 month follow up (range 12-20). Conclusion: Extension of orbital adnexal marginal zone lymphoma to peripheral blood is a newly recognized phenomenon that may be present in a sizeable portion of these patients (14% in this limited study). Bilateral extranodal marginal zone lymphoma may have an increased risk of clonal or atypical circulating lymphocytes. However, such peripheral involvement appears to have benign systemic ramifications which may require observation only.
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