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Malignant conjunctival T cell lymphoma diagnosed by punch biopsy as a primary manifestation of systemic cancer.

Isola V, Mazzacane D, Defelice N, D'Amico A, Dezza L, Marti A, Pece A - Clin Ophthalmol (2012)

Bottom Line: A biopsy specimen of the conjunctival mass was found histopathologically to be a malignant T cell lymphoma.Systemic involvement was diagnosed within four weeks after the initial diagnosis by computed tomography, showing evidence of extension at the level of the ethmoidal cells, optic nerve, periorbital tissue, and pancreas.T cell lymphoma of the conjunctiva as a primary manifestation of systemic cancer is an uncommon entity.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Melegnano Hospital, Milan, Italy.

ABSTRACT
This report documents a case of T cell lymphoma manifesting only with a conjunctival mass. A 67-year-old man underwent a diagnostic punch biopsy, histopathological examination, and immunohistochemical study for a pink-yellow colored mass infiltrating the bulbar conjunctiva in the lower fornix of the eyelid. A biopsy specimen of the conjunctival mass was found histopathologically to be a malignant T cell lymphoma. Systemic involvement was diagnosed within four weeks after the initial diagnosis by computed tomography, showing evidence of extension at the level of the ethmoidal cells, optic nerve, periorbital tissue, and pancreas. T cell lymphoma of the conjunctiva as a primary manifestation of systemic cancer is an uncommon entity. Punch biopsy may be the first diagnostic pathway useful to initiate a search for systemic involvement of a malignant lymphoid tumor of T cell lineage.

No MeSH data available.


Related in: MedlinePlus

(A and B) CD3 and Ki67 immunoreactivity (ABC peroxidase, 40×).
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f3-opth-6-777: (A and B) CD3 and Ki67 immunoreactivity (ABC peroxidase, 40×).

Mentions: A control visit showed disappearance of corneal ulcer, and a diagnostic punch biopsy of the conjunctival mass was taken for immunohistochemical examination. The conjunctiva was infiltrated by a diffuse proliferation of small- to medium-sized lymphoid cells which were partly necrotic. The lymphoid population showed nuclear atypia, vesicular nuclei, and prominent nucleoli. Focal effacement of the serous glands of the conjunctiva was observed (Figure 2). The neoplastic cells were homogeneously CD3+, CD5−, CD20−, and CD43(MT1)+/−. A high proliferation rate reaching 80% of the neoplastic population was observed, as detected by Ki67/MIB1 immunoreactivity (Figure 3A and B). Over the next two weeks, the patient had ptosis and exophthalmos in the right eye. Slit-lamp biomicroscopy revealed was followed carefully by the oncology service for staging that was classified as IVB. He was receiving a regimen of chemotherapy comprising cyclophosphamide 750 mg/mq, epidoxorubicin 50 mg/mq, vincristine 1.4 mg/mq, and prednisone 50 mg/mq on days 1 and 5. Simultaneously, the patient underwent locoregional radiotherapy with a total of 20 Gy to the retro-orbital region. The patient died of an acute myocardial infarction after the two cycles of chemotherapy.


Malignant conjunctival T cell lymphoma diagnosed by punch biopsy as a primary manifestation of systemic cancer.

Isola V, Mazzacane D, Defelice N, D'Amico A, Dezza L, Marti A, Pece A - Clin Ophthalmol (2012)

(A and B) CD3 and Ki67 immunoreactivity (ABC peroxidase, 40×).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3367434&req=5

f3-opth-6-777: (A and B) CD3 and Ki67 immunoreactivity (ABC peroxidase, 40×).
Mentions: A control visit showed disappearance of corneal ulcer, and a diagnostic punch biopsy of the conjunctival mass was taken for immunohistochemical examination. The conjunctiva was infiltrated by a diffuse proliferation of small- to medium-sized lymphoid cells which were partly necrotic. The lymphoid population showed nuclear atypia, vesicular nuclei, and prominent nucleoli. Focal effacement of the serous glands of the conjunctiva was observed (Figure 2). The neoplastic cells were homogeneously CD3+, CD5−, CD20−, and CD43(MT1)+/−. A high proliferation rate reaching 80% of the neoplastic population was observed, as detected by Ki67/MIB1 immunoreactivity (Figure 3A and B). Over the next two weeks, the patient had ptosis and exophthalmos in the right eye. Slit-lamp biomicroscopy revealed was followed carefully by the oncology service for staging that was classified as IVB. He was receiving a regimen of chemotherapy comprising cyclophosphamide 750 mg/mq, epidoxorubicin 50 mg/mq, vincristine 1.4 mg/mq, and prednisone 50 mg/mq on days 1 and 5. Simultaneously, the patient underwent locoregional radiotherapy with a total of 20 Gy to the retro-orbital region. The patient died of an acute myocardial infarction after the two cycles of chemotherapy.

Bottom Line: A biopsy specimen of the conjunctival mass was found histopathologically to be a malignant T cell lymphoma.Systemic involvement was diagnosed within four weeks after the initial diagnosis by computed tomography, showing evidence of extension at the level of the ethmoidal cells, optic nerve, periorbital tissue, and pancreas.T cell lymphoma of the conjunctiva as a primary manifestation of systemic cancer is an uncommon entity.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Melegnano Hospital, Milan, Italy.

ABSTRACT
This report documents a case of T cell lymphoma manifesting only with a conjunctival mass. A 67-year-old man underwent a diagnostic punch biopsy, histopathological examination, and immunohistochemical study for a pink-yellow colored mass infiltrating the bulbar conjunctiva in the lower fornix of the eyelid. A biopsy specimen of the conjunctival mass was found histopathologically to be a malignant T cell lymphoma. Systemic involvement was diagnosed within four weeks after the initial diagnosis by computed tomography, showing evidence of extension at the level of the ethmoidal cells, optic nerve, periorbital tissue, and pancreas. T cell lymphoma of the conjunctiva as a primary manifestation of systemic cancer is an uncommon entity. Punch biopsy may be the first diagnostic pathway useful to initiate a search for systemic involvement of a malignant lymphoid tumor of T cell lineage.

No MeSH data available.


Related in: MedlinePlus