P 142Conjunctival CD5+ MALT lymphoma: A case report
A. H. Heuring1,3, F. E. Franke2, H. B. Eckhardt3, W. W. Hütz3
Background: NHL, arising from mucosa-associated lymphoid tissue (MALT) and the marginal zone of lymph follicles, are classified as MALT lymphoma. This type of lymphoma often have a history of chronic inflammation or autoimmune disease. Histopathologic features of MALT lymphoma consist of a diffuse and parafollicular growth pattern and the presence of lymphoepithelial lesions.The tumor cells express monotypic surface Ig (sIg) and sometimes cytoplasmic Ig (cIg) (usually IgM), moreover the pan B-cell antigens CD19, CD20, CD22, and CD79a. Typically, they are negative for CD5, CD10, and CD23. Til now, only a few CD5+ cases have been reported in the literature.
Case report: A 79-year old male, suffering from an unilateral idiopathic non-specific anterior uveitis for 30 years, presented with an indolent nodular tumor within the epibulbar conjunctiva of the contralateral eye. This reddish lesion of 1.5 cm in diameter appeared circumscribed, but magnetic resonance imaging (MRI) demonstrated a lymphoma-like diffuse and intraorbital extension reaching the optic nerve. Histological and immunohistochemical examinations after biopsy confirmed the diagnosis of a low-malignant B-cell non-Hodgkin`s lymphoma (NHL), which was further classified as marginal zone lymphoma (MZL) of the mucosa associated lymphoid tissue (MALT-type). This NHL, clinically identified as the primary lesion, showed an unusual expression of the T-cell antigen CD5. Nodal or systemic involvement was not found. There were no recurrences within the 18-month of follow-up after radiotherapy (40 Gy, fractions of 2 Gy/day, 5 days/week).
Discussion: Differential diagnosis in our patient include the CD5+ NHL, but chronic lymphocytic B-cell leukemia (B-CLL) and mantle cell lymphoma (MCL) could be excluded because of different morphological and phenoypic features, furthermore both diseases are more aggressive than MALT lymphoma and usually not curable.
1Department of Ophthalmology,Otto von Guericke University Magdeburg, Germany
2Department of Pathology, Justus Liebig University Giessen, Germany
3Eye-Hospital Bad Hersfeld, Germany