Clinicopathological analysis of mucosa associated lymphoid tissue lymphoma secondary to Sjögren' s syndrome in salivary gland / 北京大学学报(医学版)

OBJECTIVE@#To analyze the clinicopathological characteristics of mucosa associated lymphoid tissue (MALT) lymphoma secondary to Sjögren' s syndrome (SS) (SS-MALT lymphoma) in salivary gland and to explore the value of the combined application of histopathological morphology, protein expression and molecular phenotype in pathological diagnosis and prognostic evaluation of SS-MALT lymphoma.@*METHODS@#Sixteen patients with SS-MALT lymphoma were collected from 260 patients who were diagnosed with SS in Peking University School and Hospital of Stomatology from January 1997 to December 2016. Twelve patients with non-MALT lymphoma secondary to SS (non-SS-MALT lymphoma) in salivary gland were selected as controls. The clinical data of the patients were retrospectively reviewed and analyzed. All the patients were followed up until December 20, 2019. Hematoxylin-eosin staining, immunohistochemistry, polymerase chain reaction (PCR) and fluorescence in situ hybridization (FISH) techniques were used to observe the histologic characteristics and to detect the manifestations of light chain restrictive expression, immunoglobulin (Ig) gene clonal rearrangement, chromosome translocation and gene abnormality, so as to evaluate their values in pathological diagnosis and prognostic evaluation.@*RESULTS@#The malignant transformation rate of SS to MALT lymphoma was about 6.15%, ranged from 3 to 240 months, during which 2 patients died due to high-level deterioration. Microscopically, the acini of the glandular tissue were atrophied and destroyed. The tumor cells dominated by central cell-like lymphocytes grew diffusely, destroying the epithelial islands. All SS-MALT lymphoma cases were positive in CD20 and Pax5. Half of them had the Ki-67 proliferation index of 10% or less, and half greater than 10%. 93.75% cases expressed AE1/AE3 protein, which showed the residual glandular epithelium. All the tumor cells were negative in CD3ε, and the plasma cells were detected by CD138 antigen. The light chain restrictive expression of κ and λ was 37.5% in SS-MALT lymphoma group. The positive detection rates of immunoglobulin heavy chain (IgH)-FR1, IgH-FR2, IgH-FR3, immunoglobulin kappa chain (IgK)-A, and IgK-B in SS-MALT lymphoma group were 33.3%, 53.3%, 33.3%, 20.0%, and 26.7%, respectively, and 93.3% when together used with IgH and IgK. The positive rates of the MALT1, IGH and BCL6 genes with dual color break-apart probes were 36.4%, 27.3% and 27.3%, and the detection rate of chromosome translocation and gene abnormality by applying the three probes was 72.7%.@*CONCLUSION@#There are no specific histological characteristics and protein phenotypes in the histologic diagnosis of SS-MALT lymphoma in salivary gland. The combined application of histopathological manifestations, immunohistochemistry, PCR and FISH techniques helps the accurate pathologic diagnosis of the disease. Although SS-MALT lymphoma is considered as an indolent lymphoma with a relatively favorable prognosis, the regular return visit and long-term follow-up should be conducted to detect the clues of recurrence and advanced deterioration.

Relationship between macular retinal thickness and visual acuity in high myopia / 中华实验眼科杂志

Background It is well known that the diminution of visual acuity appears before notable complications in some high myopic eyes.However,whether the impaired vision is associated with the change of retinal thickness at macula area is still under investigation.Objective This study was to investigate the relationship of macular retinal thickness with the change of visual acuity in high myopic eyes.Methods A consecutive caseobservational study was performed.Two hundred and forty-five eyes of 132 patients with the diopter of-6.00～-20.00 D were enrolled in this study during the January 2011 to January 2012 in Beijing Tongren Eye Center.All of the patients received the measurement of retinal thickness with Fourier Domain Optical Coherence Tomography (FDOCT),and the scan mode was MM6.The eyes were divided into the corrected vision ≥0.9 group and the corrected vision ≤0.8 group.In addition,the eyes were assigned to the non-posterior staphyloma group,posterior staphyloma Ⅰ group (macular symmetry) and posterior staphyloma Ⅱ group (macular gradient).The retinal thicknesses in different quadrants at the macular zone were measured and calculated by OCT software.Results The demography was matched in different groups.Corrected visual acuity was significantly increased in the corrected vision ≥ 0.9 group than that in the corrected vision ≤0.8 group (1.02±0.16 vs.0.62±0.08) (t=3.233,P=0.001).Retinal thickness value at fovea was (256.28±13.19) μm in the corrected vision ≥0.9 group,and that in the corrected vision ≤0.8 group was (231.17 ± 10.96) μm,with a significant difference between the two groups (t =2.134,P =0.031).The corrected visual acuity was 1.00±0.27,0.78±0.21 and 0.90±0.13 in the non-posterior staphyloma group,posterior staphyloma Ⅰ group and posterior staphyloma Ⅱ group,respectively,showing significant difference among the three groups (F=15.760,P=0.015),and the corrected visual acuity of the non-posterior staphyloma group and posterior staphyloma Ⅱ group were significantly higher than that of posterior staphyloma Ⅰ group (q =16.131,P =0.006 ; q =-10.831,P=0.008).A significant difference also was seen in the mean retinal thickness among the three groups (F=2.316,P =0.025).The mean retinal thickness in the posterior staphyloma Ⅰ group was (234.21 ± 15.69) μm,which was significantly smaller than (252.25± 15.31) μm of the posterior staphyloma Ⅱ group (q =12.977,P =0.023).There were no significant difference in the retinal thickness at para-fovea area among the three groups (F=0.318,P =0.078).However,significant difference was found at peri-fovea area in different groups (F=1.925,P =0.013).The mean retinal thicknesses at peri-fovea area was (273.26 ± 16.37) μm in the posterior staphyloma Ⅱ group and was significantly smaller than (289.11 ± 19.30) μm of the posterior staphyloma Ⅰ group and (290.33 ± 17.12) μm of the non-posterior staphyloma group (q =-8.305,P =0.023 ; q =-7.011,P =0.012).Conclusions The retinal thickness at fovea is associated with the corrected visual acuity in high myopic eyes.The thinning of retinal thickness at the vertex of posterior staphyloma is one of causes of visual function impairment.