Purpose: To report the clinical, histopathological and molecular biological fi ndings of a primary extranodal marginal zone B-cell lymphoma (EMZL) of the uvea . Methods: Conventional histology, immunohis tochemistry a...Purpose: To report the clinical, histopathological and molecular biological fi ndings of a primary extranodal marginal zone B-cell lymphoma (EMZL) of the uvea . Methods: Conventional histology, immunohis tochemistry and polymerase chain re action for immunoglobulin heavy chain gene rearrangement (IgH-PCR) and GeneScan analysis were performed on a chorioretinal biopsy. Results: Histological examin ation of the chorioretinal biopsy demonstrated a dense infiltrate of small centr ocyte-like cells, plasmacytoid tumour cells and occasional blasts. The tumour c ellswere positive for CD20, showed monotypical expression for Ig-kappa and IgM, and a growth fraction of 10%. Clonality analysis using IgH-PCR disclosed a mo noclonal B-cell population. Following localised irradiation of 35 Gy, a complet e remission was achieved. Conclusion: This report describes a rare uveal EMZL di agnosed following investigation of a chorioretinal biopsy. Despite its rarity, o phthalmic pathologists should consider the diagnosis of a primary uveal EMZL whe n reviewing chorioretinal biopsies.展开更多
Aim:To investigate the safety and efficacy of β ray brachytherapy in treatment of vasoproliferative tumours of the retina(VTR).Methods:35 consecutive patients with symptomatic VTR were treated with a ruthenium-106(10...Aim:To investigate the safety and efficacy of β ray brachytherapy in treatment of vasoproliferative tumours of the retina(VTR).Methods:35 consecutive patients with symptomatic VTR were treated with a ruthenium-106(106Ru)plaque.Three tumours had been treated previously(two with cryotherapy;one with transpupillary thermotherapy).32 VTR(91.4%)were located in the lower half of the retina and all of them were found between the mid-periphery and the ora serrata.The mean tumour thickness was 2.8 mm.An exudative retinal detachment was present in 25 eyes(71.4%)and in 15 cases(42.9%)hard exudates were found in the macula.The major symptom was loss of vision(77.1%).Results:Brachytherapy was well tolerated by every patient.The mean applied dose was 416 Gy at the sclera and 108 Gy at the tumour apex.In all but four eyes(88.6%),it was possible to control the VTR activity.The median follow up time was 24 months.Three of the above mentioned four eyes with treatment failure had had secondary glaucoma before therapy.There was no case of radiation induced neuropathy or retinopathy.Cataract surgery was necessary for five patients.The development of epiretinal gliosis was the most common event during follow up(n=10,28.6%).The mean visual acuity decreased slightly(0.33 before and 0.29 after brachytherapy).Multivariate analysis showed that the presence of macular pathology before treatment was associated with a 6.1-fold risk of vision of 0.25 or better(p= 0.03).Conclusions:β ray brachytherapy with 1106Ru plaques was able to control the activity of VTR and retain vision.Cases with secondary glaucoma before treatment had a very poor prognosis.展开更多
文摘Purpose: To report the clinical, histopathological and molecular biological fi ndings of a primary extranodal marginal zone B-cell lymphoma (EMZL) of the uvea . Methods: Conventional histology, immunohis tochemistry and polymerase chain re action for immunoglobulin heavy chain gene rearrangement (IgH-PCR) and GeneScan analysis were performed on a chorioretinal biopsy. Results: Histological examin ation of the chorioretinal biopsy demonstrated a dense infiltrate of small centr ocyte-like cells, plasmacytoid tumour cells and occasional blasts. The tumour c ellswere positive for CD20, showed monotypical expression for Ig-kappa and IgM, and a growth fraction of 10%. Clonality analysis using IgH-PCR disclosed a mo noclonal B-cell population. Following localised irradiation of 35 Gy, a complet e remission was achieved. Conclusion: This report describes a rare uveal EMZL di agnosed following investigation of a chorioretinal biopsy. Despite its rarity, o phthalmic pathologists should consider the diagnosis of a primary uveal EMZL whe n reviewing chorioretinal biopsies.
文摘Aim:To investigate the safety and efficacy of β ray brachytherapy in treatment of vasoproliferative tumours of the retina(VTR).Methods:35 consecutive patients with symptomatic VTR were treated with a ruthenium-106(106Ru)plaque.Three tumours had been treated previously(two with cryotherapy;one with transpupillary thermotherapy).32 VTR(91.4%)were located in the lower half of the retina and all of them were found between the mid-periphery and the ora serrata.The mean tumour thickness was 2.8 mm.An exudative retinal detachment was present in 25 eyes(71.4%)and in 15 cases(42.9%)hard exudates were found in the macula.The major symptom was loss of vision(77.1%).Results:Brachytherapy was well tolerated by every patient.The mean applied dose was 416 Gy at the sclera and 108 Gy at the tumour apex.In all but four eyes(88.6%),it was possible to control the VTR activity.The median follow up time was 24 months.Three of the above mentioned four eyes with treatment failure had had secondary glaucoma before therapy.There was no case of radiation induced neuropathy or retinopathy.Cataract surgery was necessary for five patients.The development of epiretinal gliosis was the most common event during follow up(n=10,28.6%).The mean visual acuity decreased slightly(0.33 before and 0.29 after brachytherapy).Multivariate analysis showed that the presence of macular pathology before treatment was associated with a 6.1-fold risk of vision of 0.25 or better(p= 0.03).Conclusions:β ray brachytherapy with 1106Ru plaques was able to control the activity of VTR and retain vision.Cases with secondary glaucoma before treatment had a very poor prognosis.
