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首页> 外文期刊>Critical reviews in oncogenesis >Is central nervous system prophylaxis necessary in ocular adnexal lymphoma?
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Is central nervous system prophylaxis necessary in ocular adnexal lymphoma?

机译：眼附件淋巴瘤需要预防中枢神经系统吗？

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PURPOSE: To examine the frequency of metastasis to the eye and central nervous system (CNS) from ocular adnexal lymphomas and to evaluate whether CNS prophylaxis is appropriate for these tumors. PATIENTS AND METHODS: Seventy-one patients with biopsy-confirmed ocular adnexal lymphomas were evaluated between 1989 and 1995. The lymphomas were subclassified histopathologically according to the new Revised European-American Lymphoma (REAL) criteria. Molecular genetic analysis of tumor cell DNA was done by Southern blot. Patients had a complete ophthalmologic evaluation and metastatic work-up and were then routinely followed up by an ophthalmologist and a medical oncologist. RESULTS: The 34 men and 37 women studied had a median age of 67 years (23 to 92). Ocular adnexal lymphomas were situated in the orbit in 54 patients, in the conjunctiva in 14 patients, and in the eyelid in 3 patients. Bilateral involvement occurred in 11 patients. The most common histologic diagnoses were (54 patients, 76%) extra-nodal marginal zone lymphomas and small lymphocytic lymphomas in 10 patients (14%). Molecular genetic analysis performed in all patients confirmed a monoclonal B-cell population in 55 patients (77%), including a single rearrangement of the immunoglobulin heavy chain gene in 14 patients, and more than two rearrangements in 41 patients. No patients had isolated T-cell gene rearrangements. Localized ocular adnexal lymphoma was diagnosed in 43 patients (61%), 17 patients (24%) were found to have concurrent extraocular lymphoma on metastatic work-up and 11 patients (15%) had a previous diagnosis of systemic lymphoma before the onset of their ocular tumor. The median duration of follow-up was 20 months. Overall, 32 patients (45%) had tumors, which remained localized to the orbit adnexa. Eleven patients (15%) relapsed, but none had eye or central nervous system involvement nor required CNS-directed therapy. Although eight patients died, only two died as a direct result of systemic lymphoma. No patient received CNS prophylaxis with either intrathecal chemotherapy and/or radiation therapy. CONCLUSION: Ocular adnexal lymphomas are rare non-Hodgkin's B-cell lymphomas. Metastatic involvement of the eye or central nervous system is rare and CNS prophylaxis with radiotherapy or chemotherapy is unnecessary.
机译：目的：检查眼附件淋巴瘤向眼和中枢神经系统（CNS）转移的频率，并评估CNS的预防方法是否适合于这些肿瘤。患者与方法：1989年至1995年对71例经活检证实的眼附件淋巴瘤的患者进行了评估。根据新的经修订的欧美淋巴瘤（REAL）标准，淋巴瘤在组织病理学上被分类。通过Southern印迹对肿瘤细胞DNA进行分子遗传分析。对患者进行了全面的眼科评估和转移检查，然后由眼科医生和内科肿瘤医师进行常规随访。结果：研究的34名男性和37名女性的中位年龄为67岁（23岁至92岁）。眼附件淋巴瘤位于眼眶54例，结膜内14例，眼睑3例。双侧受累发生在11例患者中。最常见的组织学诊断是（54例，76％）结外边缘区淋巴瘤和10例（14％）的小淋巴细胞淋巴瘤。在所有患者中进行的分子遗传学分析证实了55名患者（77％）中的B细胞单克隆，包括14名患者中免疫球蛋白重链基因的单个重排，以及41名患者中的两次以上重排。没有患者有孤立的T细胞基因重排。在43例（61％）患者中诊断出局限性眼附件淋巴瘤，在转移性检查中发现17例（24％）并发眼外淋巴瘤，而11例（15％）在发作前已被诊断为系统性淋巴瘤。他们的眼肿瘤。中位随访时间为20个月。总体上，有32例患者（占45％）患有肿瘤，但仍局限于眼眶附件。 11名患者（占15％）复发，但无一例累及眼部或中枢神经系统，也不需要中枢神经系统治疗。尽管有8例患者死亡，但只有2例是系统性淋巴瘤的直接死亡。鞘内化疗和/或放射治疗均无预防中枢神经系统的患者。结论：眼附件淋巴瘤是罕见的非霍奇金氏B细胞淋巴瘤。眼睛或中枢神经系统的转移累及很少，并且不需要通过放射疗法或化学疗法来预防中枢神经系统。

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