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P Ferreira, D Freitas, A Figueiredo, J Deschênes, MN N Burnier; Lymphoid Hyperplasia and MALT Lymphoma of the Conjunctiva: Clinical and Imunopathological Aspects . Invest. Ophthalmol. Vis. Sci. 2002;43(13):2598.
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Purpose: analyze the clinical, histopathological and immunohistochemical features to ensure the correct diagnosis of the lymphoid tumors of the conjunctiva, as well as the prognosis of these lesions. Methods:Thirty-four conjunctival lymphoid lesions were retrieved from the Ophthalmic Pathology Registries of McGill University, Montreal – Canada. Clinical aspects such as the age and sex of the patients, localization, mobility and color of the lesion were studied, as well as the systemic evaluation at the time of diagnosis. The formalin-fixed, paraffin-embedded histopathological sections were stained for HE, PAS and immunostained for B and T cell markers. Monoclonal antibodies for immunoglobulin light chains kappa and lambda were performed in order to determine the poly or monoclonality of the lymphoid tumors. Results:Fifteen of the 34 cases represented MALT B cell lymphoma of the conjunctiva and 19 cases were diagnosed as conjunctival lymphoid hyperplasia. All primary lymphoid infiltrates of the conjunctiva were localized in the conjuctiva bulbae. These infiltrates were unilateral, mobile and reddish in color, also referred to as «salmon patch». The average of the age of patients with lymphoid hyperplasia was in the fifth decade and those with MALT lymphoma of the conjunctiva was in the sixth decade. There was no difference between males and females. Epithelial infiltration was found in both MALT lymphoma and lymphoid hyperplasia. All 15 MALT lymphomas disclosed at least 80% of B cells and a monoclonal proliferation of kappa light chain in 10 cases, and lambda light chain in 5 cases. Conclusion:The histopathologic features used to differentiate MALT lymphoma and lymphoid hyperplasia include the number of Dutcher bodies and mitotic activity. Statistical analyses proved that monoclonality as well as the number of B and T cells are fundamental to the diagnosis of conjunctival lymphoid lesions. Follow up information showed that MALT lymphomas of the conjunctiva have a favorable prognosis and in the great majority of cases do not reveal systemic manifestation.
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