The Prognosis of Ocular-adnexal Lymphoproliferative Lesions

ABSTRACT

PURPOSE: Lymphoproliferative lesions of the ocular adnexa were analyzed to examine the final outcome, recurrence and extraorbital spread. METHODS: The biopsies and clinical follow up data for 55 patients (68 eyes) with ocular adnexal lymphoproliferative lesions were reviewed retrospectively and analyzed according to the WHO classification. RESULTS: The ocular-adnexal lymphoproliferative lesions were located as follows orbit in 49 eyes, conjunctiva in 18 eyes, eyelid in 1 eye. The three main subtypes of lymphoma according to the WHO classification were extranodal marginal zone B-cell lymphoma of mucosa- associated lymphoid tissue (MALT-lymphoma) (62 eyes), diffuse large B-cell lymphoma (2 eyes), and benign lymphoid hyperplasia (4 eyes). Remission was achieved at 60eyes. Recurrence was occurred in 7eyes (orbit 4, conjunctiva 3) of MALT-lymphoma cases. Location of lymphoma at presentation was not a predictor for recurrence (conjunctiva 16.7%, orbit 8.2%; p>0.05), but bilaterality at presentation was predictive values for recurrence by a statistically significant difference(bilateral 23.1%, unilateral 4.8%; p=0.045). CONCLUSIONS: Most common ocular adnexal lymphoma in Korea was MALT- lymphoma (91.2%). Bilaterality has a predictive values on recurrence, and extraorbital spread was found only in orbital MALT-lymphoma. It is suggested that orbital MALT- lymphoma should be treated with excisional biopsy and subsequent low dose radiotherapy and followed up indefinity.