Original articleOcular Adnexal Mucosa-Associated Lymphoid Tissue Lymphoma with Polyclonal Hypergammaglobulinemia
Section snippets
Patients
The medical records of 81 patients with primary ocular adnexal MALT lymphoma who were examined between April 4, 2001 and August 30, 2007 were evaluated. Patients with a history of extraocular lymphoma were excluded. A complete medical history and laboratory data that included gammaglobulin levels were obtained for each patient, and patients with gammaglobulin levels of 2.0 g/dl or higher were classified as having hypergammaglobulinemia. Of the 81 patients, eight were found to have
Patient Clinical Data
Table 1 shows age, gender, lesion location, clinical stage, treatment, and outcome for all patients included in this study. Age and gender of the patients with ocular adnexal MALT lymphoma were not significantly different from those of previously described ocular adnexal MALT lymphoma patients.2 The anatomic lesions were bilateral in five patients (71%), and four patients (57%) had bilateral diffuse orbital or lacrimal gland lesions (Figure). One patient had Sjogren syndrome.
Six patients (86%)
Discussion
Patients with polyclonal hypergammaglobulinemia have different degrees of elevated rheumatoid factor, sIL-2R, and IgE. Although different diseases are associated with polyclonal hypergammaglobulinemia,5 we hypothesize that the common etiology of these serologic immunologic abnormalities may be systemic immunologic imbalances induced by activated Th2 cells. CD4+ helper T cells include Th1 cells and Th2 cells, which regulate each other;6 the immunologic imbalances induced by activated Th2 cells
Toshinobu Kubota, MD, has worked at National Hospital Organization, Nagoya Medical Center, a medical referral center in the middle of Japan. He graduated from the Mie University School of Medicine in 1992 and completed his residency in Ophthalmology at the Nagoya University School of Medicine in 1997. Dr Kubota has been engaged in research on ocular oncology, orbital diseases, and tumors.
References (14)
- et al.
Ocular adnexal lymphoma: a review of clinicopathologic features and treatment options
Blood
(2006) - et al.
High incidence of autoimmune disease in Japanese patients with ocular adnexal reactive lymphoid hyperplasia
Am J Ophthalmol
(2007) - et al.
Retrospective cohort study of 148 patients with polyclonal gammopathy
Mayo Clin Proc
(2001) - et al.
Th2 cells in systemic autoimmunity: insights from allogeneic diseases and chemically-induced autoimmunity
Immunol Today
(1991) - et al.
Ocular adnexal lymphoma: a clinicopathologic study of a large cohort of patients with no evidence for an association with Chlamydia psittaci
Blood
(2006) - et al.
Influence of rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone on serologic parameters and clinical course in lymphoma patients with autoimmune diseases
Ann Oncol
(2007) - et al.
Response to B-cell depleting therapy with rituximab reverts the abnormalities of T-cell subsets in patients with idiopathic thrombocytopenic purpura
Blood
(2007)
Cited by (0)
Toshinobu Kubota, MD, has worked at National Hospital Organization, Nagoya Medical Center, a medical referral center in the middle of Japan. He graduated from the Mie University School of Medicine in 1992 and completed his residency in Ophthalmology at the Nagoya University School of Medicine in 1997. Dr Kubota has been engaged in research on ocular oncology, orbital diseases, and tumors.
See accompanying Perspective on page 941.