RESUMO
PURPOSE: To detect Chlamydia pneumoniae (C. pneumoniae) gene in a patient with bilateral orbital musoca-associated lymphoid tissue (MALT) lymphoma. DESIGN: Interventional case report. METHODS: A 47-year-old Chinese man with recurrent bilateral orbital masses underwent surgical biopsy. Ophthalmologic and radiographic examinations, routine histology, immunohistochemistry, and molecular analysis for immunoglobulin heavy chain (IgH), bcl-2/IgH gene translocation, and Chlamydia genes were performed. RESULTS: Pathology revealed orbital MALT lymphoma with B-cell monoclonality. In addition to IgH gene rearrangement, C. pneumoniae DNA was detected in the lymphoma. CONCLUSIONS: The finding of C. pneumoniae molecular signatures in this case suggests a possible association of Chlamydia and orbital MALT lymphoma. The infection may contribute to the development of the lymphoma.
Assuntos
Infecções por Chlamydophila/microbiologia , Chlamydophila pneumoniae/isolamento & purificação , Infecções Oculares Bacterianas/microbiologia , Linfoma de Zona Marginal Tipo Células B/microbiologia , Neoplasias Orbitárias/microbiologia , Antineoplásicos Alquilantes/uso terapêutico , Infecções por Chlamydophila/diagnóstico por imagem , Infecções por Chlamydophila/patologia , Chlamydophila pneumoniae/genética , Clorambucila/uso terapêutico , DNA Bacteriano/análise , Infecções Oculares Bacterianas/diagnóstico por imagem , Infecções Oculares Bacterianas/patologia , Rearranjo Gênico , Genes Bacterianos , Genes de Imunoglobulinas/genética , Glucocorticoides/uso terapêutico , Humanos , Cadeias Pesadas de Imunoglobulinas/genética , Linfoma de Zona Marginal Tipo Células B/diagnóstico por imagem , Linfoma de Zona Marginal Tipo Células B/patologia , Masculino , Pessoa de Meia-Idade , Neoplasias Orbitárias/diagnóstico por imagem , Neoplasias Orbitárias/patologia , Reação em Cadeia da Polimerase , Prednisona/uso terapêutico , Proteínas Proto-Oncogênicas c-bcl-2/genética , Tomografia Computadorizada por Raios XRESUMO
PURPOSE: To search for the presence of, and qualitatively characterize the microscopic anatomy of, nerve terminals in the tendino-scleral (enthesial) area of the extraocular muscle tendon. METHODS: Extraocular rectus muscle tendino-scleralspecimens from a macaque monkey, a normal human, cadavers, and patients with congenital nystagmus were obtained and studied with transmission electron microscopy. RESULTS: Enthesial neurovascular structures were identified in all specimens. The enthesial area showed structures consisting of myelinated and unmyelinated nerve fibers with associated supporting vascular capillaries. Qualitative analysis showed anomalous neurovascular structures were in the enthesis of patients with congenital nystagmus. CONCLUSIONS: This study confirms the presence of normal and abnormal neural anatomy in the enthesial area of the extraocular muscle tendon. Neurovascular abnormalities in the enthesial part of the extraocular muscle tendon may be a result of, or contribute to, disease pathogenesis. If these structures are related to afferent central nervous system input, then disruption of them during surgery might influence postoperative outcome.