Comparison of biological behavior of lacrimal gland adenoid cystic carcinoma with high-grade transformation cells.

AIM: To evaluate the differences between human lacrimal gland adenoid cystic carcinoma with high-grade transformation (LACC-HGT) primary cells cultured by high-grade transformation tissue and non-high-grade transformation (non-HGT) primary cells cultured by non-high-grade transformation tissue in proliferation, metastasis, drug susceptibility, and genes. METHODS: LACC-HGT primary cells were established by tissue block culture, and the 4th to 10th generation primary cells were selected as research objects. The cells were preliminarily identified by immunofluorescent staining. The differences between non-HGT and LACC-HGT primary cells in terms of proliferation, metastasis, and drug susceptibility were compared by cell counting kit-8 (CCK-8) assay, wound healing, and drug sensitivity experiments. Differentially expressed genes were screened using mRNA array. Gene expression was analyzed using real-time quantitative polymerase chain reaction (RT-qPCR). RESULTS: LACC-HGT primary cells were successfully cultured by tissue block culture. Immunofluorescence staining results showed that cytokeratin (CK) and CK7 expression levels were positive in LACC-HGT primary cells. CCK-8 results showed that the proliferation ability of LACC-HGT cells was significantly higher than that of non-HGT cells. Wound healing experiment showed that the migration ability of LACC-HGT cells was significantly higher than that of non-HGT cells. LACC-HGT cells were also less sensitive to cisplatin and paclitaxel than non-HGT cells. Compared with non-HGT cells, 9566 differentially expressed genes were found in LACC-HGT primary cells, of which 5162 were up-regulated and 4404 were down-regulated. The expression of N-acetylneuraminate pyruvate lyase (NPL), MARVEL domain containing 3 (MARVELD3), syntabulin (SYBU), and allograft inflammatory factor 1 (AIF1) was higher in LACC-HGT cells than in non-HGT cells, whereas that of periostin (POSTN) was lower. CONCLUSION: LACC-HGT primary cells have faster proliferation, stronger migration ability, and poorer sensitivity to chemotherapy drugs than non-HGT primary cells. The expression of mRNAs in non-HGT and LACC-HGT primary cells are significantly different. These features are speculated to be the reasons why high-grade transformation tissues exhibit higher malignant degree and poorer prognosis than their counterparts.

[Primary culture and morphological characteristics of human lacrimal adenoid cystic carcinoma cells].

OBJECTIVE: To explore a method of primary culturing human adenoid cystic carcinoma cells of lacrimal gland. METHODS: Experiment research. Tumor tissue was obtained from the surgical material of a patient diagnosed as lacrimal adenoid cystic carcinoma in Tianjin Medical University Eye Hospital during May 16th to June 1st.We gained primary cells via tissue culture techniques. Mixed cells were removed through several ways.Observed cell morphological characteristics by phase contrast microscope, scanning electron microscope and transmission electron microscope. Cyto-immunochemical staining was applied to detect the expressions of vimentin, desmin, S-100, cytokeratin, pan and CD34. Their expressions were also detected in the tumor tissue except CD34. Made cell growth curve and calculated cell doubling time. RESULTS: The outgrowth of cells was observed by day 5 after seeding tissues, and then cells generated slowly. The first passage proceeded by day 32, and the classical epithelioid cell colonies was observed by day 69 after inoculation. Purified cells of human lacrimal adenoid cystic carcinoma were obtained after the removal of mixed cells through several ways, which have been successfully subcultured for more than 100 passages. The 25th passage LACC cells appeared to be typically epithelioid cells, they showed contact inhibition as the density high enough.SEM and TEM showed the 25th passage LACC cells were malignant tumor cells poorly differentiated. They showed positive reaction with vimentin, cytokeratin (pan) as well as S-100, but negative reaction with desmin and CD34, which were consistent with the tumor tissue. The cell growth curve turned like a sigmoid one, and the cell doubling time was 37.1 h. CONCLUSIONS: We gained purified LACC cells, and understood the morphological characteristics, laying the foundation for the establishment of a human lacrimal adenoid cystic carcinoma cell line.

[The advance of ß-blockers in the treatment of infantile hemangiomas].

Infantile hemangiomas (IH) is the most common benign tumour in early infancy.IH often grows under skins and subcutaneous tissues around head and neck, but it is not rare in ophthalmologic clinical work.IH in the eyelids, orbit and other organs, characterized by their very rapid growth, can cause severe complications, including ptosis and translocation of eyeball. Periocular IH might cause serious visual loss through induction of strabismic, deprivational or anisometropic astigmatism.Visceral organ involvement may become life-threatening. Patients need to be treated immediately in these scenarios. Conventional treatments for IH include the use of corticosteroids, sclerosing agents, interferon, vincristine, etc., which had some side effects and also not effective to all IH.Recently, many specialized clinics reported the impressive effect of ß-blockers, mainly propranolol, in the treatment of IH. Although IH is not among the approved indications for ß-blockers, propranolol is still recommended as the first line treatment for IH. They acted as vasoconstrictors, regulating angiogenic pathways and inducing apoptosis of vascular endothelial cells. This review covered the current understanding of the indications, mechanism of action, dose regimen, administration route, treatment duration, clinical response, and adverse effects of ß-blockers in the treatment of infantile hemangiomas.

[The application of serum free medium in the research of isolating cancer stem cells].

The isolation and identification of cancer stem cells are the key points in exploring characteristics of cancer stem cells at present. Several species of cancer stem cells, for instance, retinoblastoma tumor stem cells, cancer stem cells of melanoma of choroid, breast cancer stem cells, lung cancer stem cells, colon cancer stem cells, etc., have been isolated and cultured successfully by serum free medium while their biological functions and characteristics are acquired. This review focus on the application of serum free medium in the research of isolating cancer stem cells, both ocular and general, in terms of providing foundation for further research on ocular cancer stem cells.

[Overexpression of the receptor tyrosine kinase EphA2 in choroidal melanoma: correlation with vesculogenic mimicry and prognosis].

OBJECTIVE: To study the correlation of EphA2 protein expression with vesculogenic mimicry (VM), clinicopathological characteristics and prognosis in choroidal melanoma (CM). METHODS: It was a retrospective case series study. Between January 1992 and December 2005, 56 cases of human CM with clinicopathologic data from the Second Hospital of Tianjin Medical University were studied. HE stainings were performed to observe the microcirculation patterns in tumor tissue specimens. VM was found in 26 of the 56 cases using CD31/periodic acid-Schiff (PAS) double staining and transelectron microscopy. All cases were divided into two groups: VM-positive and VM-negative. Immunohistochemical staining was performed on paraffin sections of the 56 cases of CM specimens to investigate the expression of EphA2. According to tumor cells positive rate and staining intensity of the results of evaluation, the specimens were divided into low expression and high expression groups.χ(2)-test and t-test were used to analyzed the enumeration data and measurement data, respectively. Survival analysis was used to further elucidate its correlation with clinicopathological characteristics, VM and prognosis. Cox proportional hazard model was used to analyzed the influence factors of prognosis. RESULTS: VM channels were found in 26 of the 56 CM cases and VM-negative 30 cases. VM-positivity was related to cell type, tumor size and recurrence and metastasis, and the differences were statistically significant (χ(2) = 4.612, 5.346, 5.213; P = 0.036, 0.021, 0.027). The results showed that EphA2 was up-regulated in the VM-positive group compared with the group of VM-negative group. The positive rates of EphA2 expression in the VM-positive group and VM-negative group were 92.3% (25/26) and 70.0% (21/30), respectively, with a significant difference between the two groups (t = 2.247, P = 0.009). The EphA2 protein was expressed in epithelioid (10/12), mixed (11/15) and spindle (41.40%) cell types, with a significant difference among these histological types (χ(2) = 6.513, P = 0.010). The expression rate of EphA2 protein were significantly higher in large (54.55%, 18/33) than small (45.45%, 15/33) tumors, and the expression of EphA2 in metastatic and recurrence patients (10/11) were significantly higher compared with controls (31.11%, 14/45) (χ(2) = 4.556, 8.211;P = 0.016, 0.005). Kaplan-Meier survival analysis showed the presence of VM resulted in a poor prognosis (t = 9.263, P = 0.000). The Cox proportional hazards model indicated that the EphA2 overexpression and the presence of VM were independent predictors of a poor prognosis (χ(2) = 12.041, P = 0.001). Moreover, there was a significant positive correlation between them (r = 0.412, P < 0.05). CONCLUSION: The results of this study demonstrate that EphA2 may play a critical role in the formation process of VM in CM, implicating EphA2 as a valuable marker for the prediction of recurrence, metastasis and prognosis in CM patients.

[Analysis of expression of cancer stem cell-related markers in orbital adenoid cystic carcinoma].

OBJECTIVE: To observe the expression and distribution of CD44, CD133, and ABCG2 in orbital adenoid cystic carcinoma (ACC) and investigate their correlations with pathological type and prognosis. METHOD: Two steps method of immunohistochemical staining was employed in 33 cases of paraffin embedded surgical specimens of human orbital ACC, 5 cases of recurrence samples, 3 cases of an excised lacrimal gland caused by neither inflammation nor tumor diseases, and 6 cases of xenograft tumors in nude mice. A retrospective analysis was performed on the clinical material of these patients, which were collected from Jan. 1991 to Mar. 2009. RESULTS: The positive rate of CD44 was 54.5% (18/33), with 76.9% (10/13) in solid type and 40.0% (8/20) in adeno-tubiform type. There was no statistically significant difference between them (P = 0.072). In solid type the positive expression cells were often located at the marginal part of the cancer nest. In the adeno-tubiform type, positive cells were often located at the outer layer of the tubiform structure (myoepithelial cells). CD44 was also expressed in normal tissues. The positive rate of CD133 was 57.6% (19/33), with 76.9% (10/13) in solid type and 45.0% (9/20) in adeno-tubiform type. There was no significant difference between them (P = 0.087). CD133 antigen was expressed in either the cytoplasm or nucleus, or expressed in both the cytoplasm and nucleus. The positive rate of ABCG2 was 21.2% (7/33), with 30.77% (4/13) in solid type and 15.0% (3/20) in adeno-tubiform type. There was no significant difference between them (P = 0.393). Many positive cells surrounded the vessels in tumor tissues. There were no significant differences between different prognosis groups of these surface phenotypes. The correlative analysis results of three surface phenotypes showed that CD44(+) cells have positive correlation with CD133(+) cells (Spearman, r(s) = 0.416, P = 0.016). In six transplanted tumors of nude mice, the number of positive cases for CD44(+), CD133(+) and ABCG2(+) was 1, 1 and 4 cases, respectively. CONCLUSIONS: The expression of CD44, CD133 and ABCG2 in ACC may influence the progress of ACC. However, they cannot be used as the markers for the evaluation of the prognosis of this tumor.

Inhibition of tumor growth and vasculogenic mimicry by curcumin through down-regulation of the EphA2/PI3K/MMP pathway in a murine choroidal melanoma model.

This study aims to investigate the underlying mechanism by which curcumin inhibits tumor growth and reduces vasculogenic mimicry (VM) in a murine choroidal melanoma model. Sixty mice were given subretinal injection with B16F10 cells and divided into a treatment and a control group. Curcumin was administered to the treatment group once a day at a dose of 100 mg/kg for 18 days starting at d3 (the day of inoculation is designated as d0); an equivalent volume of poloxamer-F68 was administered to the control group. Immunohistochemical and histochemical double staining were ued to detect the different blood supply patterns. The amounts of epithelial cell kinase (EphA2), phosphatidylinositol-3-kinase (PI3K), and matrixmetalloproteinase-2 and -9 (MMP-2, MMP-9) proteins expressed in the tumor tissue were analyzed using immunohistochemical staining; mRNA levels were measured using real-time PCR analysis. Results indicate that the tumor volume is reduced (P=0.000) and that the numbers of VM (P=0.000), mosaic vessels (P=0.031), and endothelium-dependent vessels (P=0.000) are significantly decreased by curcumin (P=0.001). The expression levels of EphA2, PI3K, MMP-2, and -9 are also lower in the treatment group than in the control group (P=0.001); similarly, mRNA levels in the treatment group are lower than those in the control group (P=0.000). In conclusion, curcumin has the ability to inhibit the growth of engrafted melanoma VM channels through the regulation of vasculogenic factors that could be related to the down-regulation of the EphA2/PI3K/MMPs signaling pathway. Thus, curcumin has the potential of being a clinical inhibitor of VM of choroidal melanoma.

[VCR-loaded nanoparticles as targeted delivery system for the treatment of orbital adenoid cystic carcinoma].

OBJECTIVE: To prepare and observe the properties of Folate Receptor-mediated VCR-loaded nanoparticles, which is abbreviated as FA-PLGA (VCR)-NP and to study the inhibitory effect of FA-PLGA (VCR)-NP in ACC-2 cells in vitro and in ACC in BALB/c-nu mice. METHODS: The mAified W/O/W extraction-evaporation technique was chosen to prepare FA-PLGA (VCR)-NP. Tumor cells were divided into three groups: VCR, PLGA (VCR)-NP and FA-PLGA (VCR)-NP. Seven doses (0.05, 0.25, 0.50, 1.00, 5.00, 10.00, and 30.00 mg/L) of VCR were tested in the cell culture mAel. After 1, 2, 3, 4 and 5 days, the cell growth inhibition ratio was evaluated by MTT colorimetry. Nude mice mAel of orbital ACC was built by injecting ACC cell suspension and divided into four groups: VCR, PLGA (VCR)-NP, FA-PLGA (VCR)-NP, and control group. After 1 day, 7 days and 14 days, the inhibition ratio of gross tumor volume was observed. Residual concentrations of VCR in tumors were evaluated by HPLC. The feature of histopathology was observed by electron microscopy. The effect of empty nanoparticles on ACC-2 cells was compared with normal control group using t-test to analyze. On account of different drugs, concentration, time and the interaction of them, multivariate analysis of variance was used to analyze their relationship. Inhibition rate and residual volume of drug concentrations were compared using one-factor analysis of variance and LSD method. RESULTS: FA-PLGA (VCR)-NP were smooth and spherical with a mean particle size of 249.2 nm. The drug loading efficiency was 4.53%. The release of VCR from PLGA nanoparticles can persist for 14 d. After blank particles PLGA-NP and ACC-2 cells were co-cultured for 5 days, cell viability had remained at more than 80 percent (t = 1.952 ∼ 3.285, P = 0.081 ∼ 0.190). The inhibitory effect of FA-PLGA (VCR)-NP was more effective than VCR alone after a period of time (F = 4.798 ∼ 563.479, P = 0.000 ∼ 0.006). The effects of the treatment were both in dose-dependent and time-dependent manner. Targeting particles could attach to tumor surface, via folate receptor. FA was competitive inhibitor of this recolonization. The volume inhibition ratios of FA-PLGA (VCR)-NP and PLGA (VCR)-NP were significant higher than VCR (P = 0.016, P = 0.029). The inhibition ratio of FA-PLGA (VCR)-NP was higher than that of PLGA (VCR)-NP, but there was no statistical difference (P = 0.376). There was significant different between residual concentrations of VCR on the 1(st), 7(th) and 14(th) days. TEM pictures showed a mass of electron-dense microspheres in tumor cells on the 14(th) day. Tumor necrosis was obvious, while surrounding tissues were normal. CONCLUSIONS: FA-PLGA (VCR)-NP are stable and have high drug entrapment efficiency and high effect of growth inhibition in vitro. It can be proposed as a potentially controlled and targeted delivery system for the treatment of ACC.

[Clinical analysis of primary extraocular muscles tumors].

OBJECTIVE: To analyze the clinical manifestation of primary extraocular muscles tumors and to study the diagnosis and therapy of this disorder. METHODS: Retrospective analysis of the clinical data of all primary extraocular muscles tumors (the diagnosis was confirmed by operation and pathological examination) in our hospital. RESULTS: There were 9 cases of primary extraocular muscle tumors. Six cases involved the internal rectus, 2 cases involved the external rectus, 1 case involved both inferior rectus and inferior oblique. Three cases involved the total length of the muscle; 2 cases involved the anterior muscle tendon and belly, 3 cases involved the posterior muscle tendon and belly, 1 case involved the muscle belly only. There were 3 cases of venous hemangioma, 2 cases of fibroangioma, 2 cases of neurilemoma, 1 case of fibrous histiocytoma and 1 case of paraganglioma. Image examination showed significant enlargement of extraocular muscle with clear boundary. B-scan ultrasonography, color Doppler flow image, CT and MRI scan showed different features. Patients were treated by excision of the tumor. Transplantation of the rectus was performed in several cases after the excision of the muscle. CONCLUSIONS: Vascular tumors are the most common type of primary extraocular muscle tumors. Congestion and swelling can be observed at the insertion of the rectus. The eyeball is proposed and moved to the opposite side of the affected muscle. Changes in the image analysis are related to the pathologic features. A good therapeutic results can be achieved by surgical excision of the tumor.

[The mechanisms of microenvironments influence on vasculogenic mimicry between intraocular and subcutaneous melanoma].

OBJECTIVE: To investigate the influence of different microenvironments on melanoma vasculogenic mimicry, invasiveness and metastasis behavior. METHODS: It was an experimental study. Sixty C57BL/6J mice were randomly divided into two groups with 30 mice per group. Melanoma B16 cells were injected into the subretinal space and groin area of mice synchronously. The number of each type of microcirculation pattern was counted. The invasion and metastasis were observed. EphA2, MMP-2 and MMP-9 expression and their mRNA levels were detected by immunohistochemical staining and real time RT-PCR and compared between two groups. RESULTS: Five invasions and six lung metastases were found in the subretinal group while no invasion and metastasis were found in the groin group. The number of VM channels was significantly higher in subretinal group (t = 4. 188, P = 0.000). However, no significant difference of mosaic vessel and endothelium-dependent vessel was observed between two groups (t = 1.473, 1.805; P = 0.146, 0.076, respectively). EphA2, MMP-2 and MMP-9 expression was significantly higher in the subretinal group (data not shown). The mRNA levels of EphA2, MMP-2 and MMP-9 were rather higher in the subretinal tumor (t = 3.642, 8.109, 9.357; P = 0.002, 0.001 and 0.001, respectively). There was a positive association in melanoma cells of the VM between expression of EphA2 (r = 0.412, P = 0.021) but no statistically significant correlation between VM and MMP-2 (P > 0.05), nor between VM and MMP-9. CONCLUSIONS: Different microenvironments affect invasiveness and blood supply patterns of melanoma. Melanoma cells in intraocular microenvironment increased EphA2 expression which induced the formation of VM channels. Moreover, the expression of MMP-2 and MMP-9 in tumor tissue increased to enhance the invasiveness and metastasis behavior.

[Etiology, diagnosis and treatment analysis of 37 cases with orbital fistula].

OBJECTIVE: To present some instruction in diagnosis and treatment of the orbital fistula by analyze the clinical manifestation. METHOD: The clinical data for 37 cases with orbital fistula treated during 1980 to 2007 were analyzed retrospectively. RESULTS: Among 37 cases with orbital fistula, there are 21 cases caused by foreign bodies, including 17 cases by retained wooden bodies, 3 cases by iatrogenic foreign bodies and 1 case by firecrackers. There are 9 cases caused by orbital cysts, including 5 cases dermoid cysts, 3 cases epidermoid cysts and 1 case frontal mucopyocele. There are 6 cases orbital infection inflammation, including 5 cases osteomyelitis and 1 case orbital abscess. There is 1 case eosinophilic granuloma. Different etiologies have characteristic features. Medical history, fistula examinations and imaging examinations must be analyzed synthetically in order to make proper etiological diagnosis. Eradicate etiologies and resect fistula are most important. It is necessary to make an ancillary therapy, such as ENT treatment. CONCLUSIONS: The common etiologies of orbital fistula are retained foreign body, dermoid cysts and osteomyelitis. The pathogenesis include infective inflammation, congenital heteroplasia, operation and tumor. B-scan ultrasonography, CT, and MRI can be used for the localization and qualitation diagnosis. There are comprehensive approaches for diagnosis and management of this type of injury. In order to give an effective therapy, we must make an accurate diagnosis and analyze the features of fistula.

[Analysis of treatment and prognosis of orbital adenoid cystic carcinoma].

OBJECTIVE: To summarize the treatment outcomes of orbital adenoid cystic carcinoma and to evaluate prognostic factors. METHOD: A retrospective case series study was performed on 75 patients with orbital adenoid cystic carcinoma treated from 1991 to 2006. RESULTS: The 2- and 5-year local recurrence rate of solid type orbital adenoid cystic carcinoma was significantly higher than that of the adeno-tubiform type [2-year, 85% (17/20) vs 23.53% (8/34), chi(2) = 19.14, P = 0.000; 5-year, 100% (19/19) vs 64.52% (20/31), Fisher's exact test, P = 0.003]. The regional extension and distant metastasis of solid type were more than those of adeno-tubiform type. The 5-year local recurrence rate treated by postoperative radiation was lower than that treated with only surgical excision [70% (14/20) vs 92.86% (13/14); Fisher's exact test, P = 0.198]. The 5-year local recurrence rate in patients initially treated by orbital evisceration during the first time was lower than that of cases which evisceration procedure was used after the recurrence [25% (1/4) vs 75% (6/8), Fisher's exact test, P = 0.222]. Tumors may extend into intracalvarium, nasal cavity and temporal fossa. They may spread to the lung, bone, liver and lymph node. The 5-year metastasis rate was 25.71% (9/35). Both of the lung and bone metastasis rates were 33.33% (3/9). The overall 5-year accumulative survival was 74.29% (26/35), mortality was 25.71% (9/35), and rate of survival without tumor recurrence was 37.14% (13/35). The 10-year disease free survival rate was 17.14% (6/35). Patients were most likely to die with intracranial extension. Surgical excision with postoperative radiation improved the 5-year survival rate to 80% (16/20). CONCLUSIONS: Orbital adenoid cystic carcinoma is one of the most malignant tumors in the orbit. They have a high local recurrence rate and survival rate. Tumor histological types and the treatment procedure can influence the prognosis. Combined therapy may decrease the recurrence and increase the survival rate.

[The ophthalmic applications of nanotechnology].

This paper briefly reviews the researches and applications of nanotechnology in ophthalmological field recent years. Nanotechnology is the production of modern science and advanced engineering. In ophthalmological field it is generally applied on foundational investigation, medicine carrying agent, biomaterial, diagnosis and therapy. It helps us observe and control physiological and pathological phenomenon at nanometer level precisely. As new drug carriers, drug-loaded nanoparticles have lots of advantages with its targeting options and sustained drug release. As biomaterial it also has better biocompatible. It is a promising material in clinical application. The diagnosis and treatment level would be improved definitely by nanotechnology.

[Comprehensive therapy of orbital tumor].

Although the popularization of the knowledge of orbital disease is increasing, some issues such as surgery complications, recurrence, metastases may significantly affect the outcome of treatment. The new concept of comprehensive therapy offers an integrated individual therapy to patients. Application the concept in clinical practice is a key measure to improve the cured rate. In order to enhance the rate of cure of orbit tumor, it is essential for ophthalmologist to get standardized training in the diagnosis, treatment of orbital disease, and familiar with orbital anatomy and other knowledge related to orbit diseases.

[The clinical significance of calcification in orbital computed tomography].

OBJECTIVE: To study clinic significance of ocular and orbital diseases with computed tomographic (CT) scans. METHODS: 2181 ocular and orbital photos of computed tomographic scans were reviewed. The relevance with pathogenesis, diagnosis criteria and differential diagnosis of calcification was analyzed. RESULTS: Of 2181 CT scans, 129 showed calcified densities. 40 cases (31%) with retinoblastoma, and 3 cases (1%) with chorodal osteoma were revealed intraocular lesions containing calcium. The massive calcification was demonstrated in orbital diseases including 58 cases (45%) with vascular lesions, 19 (15%) cases with other orbital benign tumors and 9 cases (8%) with orbital malignant tumors. CONCLUSION: The calcification number, location and shape within lesions are of great value in the diagnosis of ocular and orbital diseases.

[Study on differential diagnosis between MALT-type lymphoma and reactive lymphoid hyperplasia of the ocular adnexa].

OBJECTIVE: To study the methods of differential diagnosis between mucosa-associated lymphoid tissue (MALT) type lymphoma and reactive lymphoid hyperplasia in ocular adnexa. METHODS: The clinical, morphologic, immunohistochemical, and molecular biologic (polymerase chain reaction [PCR]) studies were performed on 29 patients with MALT-type lymphoma and 8 patients with reactive lymphoid hyperplasia of the ocular adnexa. RESULTS: 29 cases with MALT-type lymphoma expressed B-cell markers and but T-cell makers, whereas 8 cases of reactive lymphoid hyperplasia all expressed B and T cell markers and the positive rate of T-cell marker was up to 30%. immunohistochemistry staining showed 11 cases were positive for immunoglobin light chain (kappa or lambda), however it was positive in one chain of the immunoglobin in 15 cases of MALT type lymphoma by PCR. No significant difference in the clinical characteristics was observed between the MALT type lymphoma and reactive lymphoid hyperplasia in ocular adnexa. CONCLUSION: Immunohistochemical analysis and PCR are helpful in confirming the diagnosis between the MALT-lymphoma and the reactive lymphoid hyperplasia.

[Clinical analysis of orbital histocytosis X].

OBJECTIVE: To study the clinical and imaging features together with diagnosis and management of orbital histocytosis X. METHODS: In a retrospective study from 1973 to 1999, 47 cases of histocytosis X were reviewed related with clinical materials, including eosinophilic granuloma 17 cases and Hand-Schuller- Christian disease 30 cases. RESULTS: Most occur in children and teenagers, mainly in male. Characteristic clinical features, roentgenography, ultrasonography, CT, MRI provide the most diagnostic assistance. CONCLUSIONS: Solitary unifocal eosinophilic granuloma mainly involves teenagers. Hand-Schuller-Christian disease usually take places between birth and 5 years of age, which is characterized by multifocal variant of eosinophilic granuloma, especially the classic triad. Characteristic images contribute to the diagnosis. Multiple management is needed, including surgery, chemotherapy and radiotherapy. The prognosis varies with the three types.