Ocular adnexal marginal zone B cell lymphoma infiltrated by IgG4-positive plasma cells
- 1Department of Ophthalmology, National Hospital Organization, Nagoya Medical Center, Nagoya, Japan
- 2Department of Pathology, National Hospital Organization, Nagoya Medical Center, Nagoya, Japan
- 3Department of Pathology, Okayama University Graduate School of Medical, Dentistry and Pharmaceutical Science, Okayama, Japan
- 4Department of Internal Medicine, National Hospital Organization, Nagoya Medical Center, Nagoya, Japan
- 5Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Correspondence to Toshinobu Kubota, Department of Ophthalmology, National Hospital Organization, Nagoya Medical Center, 4-1-1, Sannomaru, Naka-ku, Nagoya-shi, Aichi-ken, 460-0001, Japan;
- Accepted 26 August 2010
- Published Online First 27 October 2010
Aims To report the clinicopathological characteristics of patients with ocular adnexal marginal zone B cell lymphoma (MZBL) with IgG4-positive plasma cells.
Methods 114 biopsy samples of ocular adnexal MZBLs were analysed. MZBLs with IgG4-positive plasma cells were included when the IgG4:IgG ratio was >40% (IgG4-related group). The serum levels of each subclass of immunoglobulins and soluble interleukin-2 receptor in the IgG4-related group were compared with those in 61 consecutive patients having MZBL without IgG4-positive plasma cells (IgG4-unrelated group). They were also compared with those in 10 patients having ocular adnexal IgG4-related lymphoplasmacytic disorder (IgG4-related inflammatory group).
Results Ten (9%) of the patients were diagnosed with MZBL with IgG4-positive plasma cells. The IgG4-related group had a significantly greater degree of sclerosis and reactive follicles in the MZBLs (p=0.0004 and p=0.01, respectively). The serum levels of IgG, IgG1, IgG4, IgE and soluble interleukin 2 receptor in the IgG4-related group were significantly higher than those in the IgG4-unrelated group (p=0.003, p=0.009, p<0.0001, p<0.0001 and p=0.0007, respectively). The serum levels did not differ significantly from those of the IgG4-related inflammatory group. The IgG4-related group also had reactive IgG4-positive lymphoplasmacytic infiltrations in the recurrent lesion and in the stomach.
Conclusions IgG4-positive plasma cells had infiltrated into ocular adnexal MZBLs in 9% of cases. It is suggested that ocular adnexal MZBLs with IgG4-positive plasma cells have unique histological and serological characteristics that overlap those of ocular adnexal IgG4-related lymphoplasmacytic infiltrative disorder and systemic conditions.
Competing interests None.
Patient consent Obtained.
Ethics approval This study was approved by the Ethics Committee at Nagoya Medical Center, Nagoya, Japan.
Provenance and peer review Not commissioned; externally peer reviewed.
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