眼眶淋巴样增生病的核仁组成区相关嗜银蛋白定量研究

眼眶淋巴样增生病的核仁组成区相关嗜银蛋白定量研究黄瑞华，余英豪细胞核仁组成区嗜银蛋白（ａｒｇｅｎｔｕｍｏｆｎｕｃｌｅａｒｏｒｇａｎｉｚｅｒｒｅｇｉｏｎ，ＡＧＮＯＲ）定量技术由于检测方法简便，因而已作为一种新的指标广泛应用于良、恶性病变的诊断与鉴别诊断...     

眼眶淋巴组织增生病的核仁组成区相关嗜银蛋白定量研究

眼眶淋巴组织增生病的核仁组成区相关嗜银蛋白定量研究中国人民解放军第九五医院黄瑞华南京军区福州总医院余英豪眼眶淋巴组织增生病较为多见，其预后与组织学类型关系密切，由于病理组织学诊断误诊率各对临床预后的错误判断率均较高，给临床进一步处理带来困难，我们拟通...     

眼附属器淋巴组织增生性病变增殖细胞核抗原的表达及其与组织学分型的关系

应用增殖细胞核抗原单克隆抗体（ＰＣ１０）对眼附属器淋巴组织增生性病变３４例（炎性假瘤５例，淋巴组织反应性增生９例，不典型淋巴组织增生９例，恶性淋巴瘤１１例）标本石腊切片进行免疫组化（ＡＢＣ法）染色。结果显示炎性假瘤与反应性淋巴组织增生ＰＣＮＡ计数相差不显著（Ｐ＞０．０５），反应性增生与后二者ＰＣＮＡ计数之间均有显著的差异（Ｐ＜０．０５，Ｐ＜０．００１），不典型淋巴组织增生与恶性淋巴瘤之间阳性细胞均值差异显著（Ｐ＜０．０５）。认为ＰＣＮＡ计数有助于区别眼附属器淋巴组织增生性病变的良、恶性，本技术用于研究眼附属器淋巴组织增生性病变尚未见报道。     

眼眶淋巴组织增生病的淋巴细胞免疫表分析及其意义

使用１０种单克隆抗体，以免疫组化染色Ｓ－Ｐ法对５６例眼眶淋巴组织增生病的石蜡标本进行淋巴细胞免疫表型标记。结果表明：炎性假瘤（１５／１５）及反应性淋巴组织增生（３２／３３）显示组成细胞的多克隆性；３例不典型淋巴组织增生中，２例为单克隆性，结合组织学改变可诊断为恶性淋巴瘤；５例ＭＬ为单克隆性，经标记４例为Ｂ细胞，１例为Ｔ细胞来源。提示免疫组化染色方法有助于眼眶淋巴组织增生病良，恶性病变的鉴别诊断及Ｍ     

眼眶淋巴组织增生病的淋巴细胞免疫表型分析及其意义

使用１０种单克隆抗体，以免疫组化染色Ｓ－Ｐ法对５６例眼眶淋巴组织增生病的石蜡标本进行淋巴细胞免疫表型标记。结果表明：炎性假瘤（１５／１５）及反应性淋巴组织增生（３２／３３）显示组成细胞的多克隆性；３例不典型淋巴组织增生中，２例为单克隆性，结合组织学改变可诊断为恶性淋巴瘤（ｍａｌｉｇｎａｎｔｌｙｍｐｈｏｍａ，ＭＬ）；５例ＭＬ均为单克隆性，经标记４例为Ｂ细胞，１例为Ｔ细胞来源。提示免疫组化染色方法有助于眼眶淋巴组织增生病良、恶性病变的鉴别诊断及ＭＬ的组织学分型。文中还就眼眶淋巴组织增生病的病理分类与免疫学分类的关系进行了探讨。     

眼部淋巴增生病AgNORs的定量及免疫表型研究

目的探讨眼附属器淋巴组织增生性病变的增殖活性与组织学分型的关系．方法用银染色技术对眼部淋巴增生病34例（良性淋巴组织增生14例，不典型淋巴组织增生9例，恶性淋巴瘤11例）进行银染核仁组织区（AgNORS）定量观察。结果发现良性淋巴组织增生与后二者AgNORS颗粒数量间均有极显著性的差异（P＜0．01，P＜0．001），不典型淋巴组织增生与恶性淋巴瘤之间AgNORs颗粒数量相差不显著。结论二种技术对眼附属器淋巴组织增生性病变组织学分型有一定意义。     

角结膜缘上皮肿瘤细胞核仁组成区嗜银蛋白定量测定的图像分析

目的研究细胞核仁组成区嗜银蛋白（ａｒｇｅｎｔｕｍｏｆｎｕｃｌｅａｒｏｒｇａｎｉｚｅｒｒｅｇｉｏｎ，ＡｇＮＯＲ）定量测定对角结膜缘上皮肿瘤的病理诊断意义。方法应用自动图像分析技术及定量病理学方法，对４５例角结膜缘上皮性肿瘤（良性增生、非典型性增生、原位癌及鳞状细胞癌）进行ＡｇＮＯＲ定量测定。结果在不同的病变中，细胞核仁内嗜银蛋白颗粒的分布形态、大小及所占面积均存在差异，与病变的良、恶性，细胞的分化状况有密切关系。结论用图像分析法对角结膜缘上皮性肿瘤进行Ａｇ－ＮＯＲ含量测定，可以进一步了解各种病变组织的细胞增殖活性和分化情况，以鉴别良、恶性病变，能辅助提高病理诊断水平。     

眼部淋巴组织增生性病变PCNA和AgNORs的观察

目的：探讨眼部淋巴组织增生性病变的增殖活性与组织学分型的关系。方法：应用抗增殖细胞核抗原的单克隆抗体ＰＣ１０和ＡｇＮＯＲｓ技术，对３４例眼附属器淋巴组织增生性病变（包括良性淋巴组织增生１４例，不典型增生９例，恶性淋巴瘤１１例）的石腊切片进行检测。结果：良性淋巴组织增生与后二者ＰＣＮＡ及ＡｇＮＯＲｓ计数之间均有非常显著的差异（ＰＣＮＡ Ｐ〈０．００１，ＡｇＮＯＲｓＰ〈０．０１及Ｐ〈０．００１），不典     

睑板腺癌细胞核仁组成区嗜银蛋白与预后的关系（摘要）

睑板腺癌细胞核仁组成区嗜银蛋白与预后的关系（摘要）李洁，李洪祥，王风荣近年来应用图象分析技术进行核仁组织导体区嗜银蛋白（Ａｒｇｙｒｏｐｈｉｌｉｃｐｒｏｔｅｉｎｏｆｔｈｅｎｕｃｌｅｏｌａｒｏｒｇａｎｉｇｅｒｒｅｇｉｏｎ，ＡｇＮＯＲ）定量分析检测日益受到...     

增殖细胞核抗原及核仁组成区嗜银蛋白与视网膜母细胞瘤预后的关系

目的探讨视网膜母细胞瘤（ｒｅｔｉｎｏｂｌａｓｔｏｍａ，Ｒｂ）细胞的增殖活性与患者预后的关系。方法应用抗增殖细胞核抗原（ｐｒｏｌｉｆｅｒａｔｉｎｇｃｅｌｎｕｃｌｅａｒａｎｔｉｇｅｎ，ＰＣＮＡ）单克隆抗体ＰＣ－１０，采用ＬＳＡＢ免疫组织化学方法及Ｐｌｏｔｏｎ银染技术，对４８例Ｒｂ石蜡标本进行ＰＣＮＡ和核仁组成区嗜银蛋白（ａｒｇｙｒｏｐｈｉｌｉｃｐｒｏｔｅｉｎｓｏｆｔｈｅｎｕｃｌｅａｒｏｒｇａｎｉｚｅｒｒｅｇｉｏｎｓ，ＡｇＮＯＲｓ）检则。结果Ｒｂ组织ＰＣＮＡ标记指数（ｌａｂｅｌｉｎｇｉｎｄｅｘ，ＬＩ）与其相对应组织切片的ＡｇＮＯＲｓ计数有显著相关性（ｒ＝０．６４７，Ｐ＜０．００１）。其中行单纯眼球摘除治疗并有５年随访资料的２９例Ｒｂ中，术后存活时间≥５年组（１９例）与术后存活时间＜５年组（１０例）比较，前组的Ｒｂ组织平均ＰＣＮＡＬＩ和平均每核ＡｇＮＯＲｓ计数均显著低于后组（Ｐ＜０．０１，Ｐ＜０．０５），表明ＰＣＮＡＬＩ或ＡｇＮＯＲｓ计数与Ｒｂ预后呈明显的负相关。结论ＰＣ－ＮＡＬＩ和ＡｇＮＯＲｓ计数有助于Ｒｂ预后评估     

免疫球蛋白重链基因重排及bcl-2/JH融合基因检测眼眶淋巴细胞增生性疾病

目的：探讨检测免疫球蛋白重链（immunoglobulins heavy-chain,IgH）基因重排及bcl-2/JH融合基因在眼眶淋巴细胞增生性疾病诊断中的意义。方法：对1994年1月至1999年12月我院通过手术或活检取得的48例眼淋巴细胞增生性疾病患者眼组织的石蜡标本行光镜、免疫组织化学检查及聚合酶链反应（PCR）扩增IgH可变区第三框架区（third frame work region,FR3）基因重排及bcl-2/JH融合基因检测分析。结果：FR3重排的PCR扩增显示22例标本为淋巴细胞单克隆增生。恶性淋巴瘤、良性反应性淋巴细胞增生及淋巴细胞性炎性假瘤的阳性率分别为75．0％、40．0％及16．7％。bcl-2/JH融合基因的PCR扩增示恶性淋巴瘤的阳性率为30．0％,良性反应性淋巴细胞增生及淋巴细胞性炎性假瘤患者检查结果均为阴性。结论：PCR扩增的FR3基因重排检测对诊断眼淋巴细胞增生性疾病有重要价值;bcl-2/JH融合基因检测阳性率偏低,不宜用于临床。     

Orbital lymphoproliferative and inflammatory lesions

We reviewed the records and biopsy specimens of 38 patients with clinically similar orbital lymphoproliferative and low-grade inflammatory lesions referred to one ophthalmologist at the University of British Columbia between 1977 and 1984. Twenty-six patients had lymphoproliferative lesions, the main feature being a densely cellular population of small lymphocytes. This group was further divided into reactive lymphoid hyperplasia, malignant lymphoma, Hodgkin's disease and atypical lymphoid hyperplasia. Symptoms and signs were similar within the subgroups. The mean length of follow-up was 3.7 years. Of the 26 patients 14 had extraorbital lymphoproliferative disease, 9 had orbital recurrences and 2 died of widespread disease. Twelve patients had inflammatory lesions with distinctly different histologic features from those of the lymphoproliferative group. Symptoms and signs were similar to those in the latter group. The mean length of follow-up was 2.1 years. Four of the 12 had orbital recurrences; none had extraorbital disease or died of their disease. We feel that orbital lymphoproliferative lesions can easily be separated from clinically similar low-grade inflammatory lesions histologically and that they should be staged and followed like small lymphocytic lymphomas. Guidelines are given for handling these specimens in the laboratory.     

眼眶淋巴组织增生性病变的临床分析

目的　分析眼眶淋巴组织增生性病变患者的临床特点。方法　回顾性分析３１例眼眶淋巴组织增生性病变患者的临床资料,对其年龄、发生部位、病理特点以及其他临床特征进行分析。结果　眼眶淋巴组织增生性病变患者３１例３５眼;年龄３５～８９岁,６０岁以上者１７例;发生于泪腺８例,眶内其他部位２３例。淋巴组织增生４例４眼,淋巴组织非典型增生６例７眼,Ｂ细胞淋巴瘤１８例１９眼,霍奇金淋巴瘤１例２眼,Ｔ细胞淋巴瘤１例１眼,Ｔ／ＮＫ细胞淋巴瘤１例２眼。ＣＴ显示:未发现眶壁骨质受损。ＭＲＩ显示:Ｔ１Ｗ１为中等信号,Ｔ２Ｗ１为中偏高信号,病变可被轻到中度强化,部分明显强化。２例２眼患者侵及眼前节,出现葡萄膜炎表现,３例４眼患者存在全身病灶,１例１眼患者进行骨髓细胞学分析,发现瘤细胞存在。３１例中２５例２５眼完全切除,６例１０眼部分切除,术后给予放射治疗和（或）化学治疗。随访３～１２个月,１例２眼明确复发,５例８眼正在接受治疗,２５例２５眼未发现肿物增长。结论　眼眶淋巴组织增生性病变在临床较为常见,在发病年龄、病变发生部位、影像学以及病理学方面均有其自身特点,正确认识该疾病,对临床诊断与治疗有重要意义。     

112例眼附属器淋巴增生性病变临床组织病理学初步分析

目的初步探讨眼附属器淋巴增生性病变的发病情况、临床特征以及组织病理学特点和分型。方法收集112例经组织病理学诊断为眼附属器淋巴增生性病变患者的116份石蜡切片标本,分析归纳临床相关资料,进一步分析组织病理学特点,并根据2001年世界卫生组织淋巴及血液组织肿瘤分类方案进行重新分类诊断。结果患者年龄8～80岁,平均49岁。病程20d至22年,平均22个月。双眼患病者16例（14．3％）。临床常见表现为眼球突出、局限性肿块（69例,占61．6％）。组织病理学检查显示反应性淋巴细胞增生11例（9．8％）,非典型淋巴细胞增生10例（8．9％）,淋巴瘤91例（81．3％）。其中,黏膜相关组织型边缘带B细胞淋巴瘤74例（占淋巴瘤患者81．3％）。结论眼附属器淋巴增生性病变以黏膜相关组织边缘带B细胞淋巴瘤最为多见,好发于中老年人,临床表现为慢性迁延性病程,双眼发病并不少见。（中华眼科杂志,2005,41：871-876）     

High incidence of orbital malignant lymphoma in Japanese patients

PURPOSE: To review 244 cases of orbital tumors to determine pathologic findings in Japanese patients. DESIGN: Observational case series. METHODS: We studied the pathology and origin of tumors in the orbit in 244 consecutive Japanese patients with orbital tumors at our institution from 1981 through 2002 (age 0 to 90 years, mean, 48.7 years; 114 men, 130 women). RESULTS: The most common tumors were lymphoproliferative diseases (n = 114, 42.5%), including malignant lymphoma (n = 59, 24.1%) and reactive lymphoid hyperplasia (n = 45, 18.4%), pleomorphic adenoma (n = 21, 8.6%), and cavernous hemangioma (n = 18, 7.4%). CONCLUSION: The incidence of lymphoproliferative diseases, especially malignant lymphoma, was very high in Japanese patients.     

A prevalence study of IgG4-related ophthalmic disease in Japan

Purpose

Immunoglobulin (Ig)G4-related ophthalmic disease belongs to a category of ocular adnexal lymphoproliferative disorders, the most frequent group of orbital tumors and simulating lesions. The aim of this study was to elucidate the number of IgG4-related diseases of orbital lymphoproliferative disorders and correlate ages and sex of such patients from 18 centers in Japan.

Methods

One thousand and fourteen patients with orbital lymphoproliferative disorders were enrolled in this study. All had pathologically diagnosed lymphoproliferative disorders with surgical samples of ocular adnexal tissue. Patients with conjunctival lesions and intraocular lymphoma were excluded.

Results

Of the 1,014 cases of orbital lymphoproliferative disorders 404 (39.8 %) had extranodal mucosa-associated lymphoid tissue (MALT) lymphoma, 156 (15.4 %) had other malignant lymphomas, 191 (18.8 %) had non-IgG4 orbital inflammation, 219 (21.6 %) had IgG4-related orbital inflammation, and 44 (4.3 %) had IgG4-positive MALT lymphoma. Median age of the IgG4-related orbital inflammation group was 62 years, which is significantly lower than that of the MALT lymphoma group (median 66 years) and higher than the non-IgG4 orbital inflammation group (median 57 years). The male/female ratio was 105/114 in the IgG4-related orbital inflammation group.

Conclusions

Nearly a quarter of orbital lymphoproliferative disorders in Japan are related to IgG4.     

Gene Rearrangement Analysis of Orbital Lymphoid Infiltrating Disorders

Purpose: To determine whether the use of polymerase chain reaction for B-cell gene rearrangement in patients with orbital lymphoid infiltrate disorders could be useful in the diagnosis of lymphoma, especially, in differentiating benign lesion from malignant one. Methods: In addition to clinical, pathological, and immunohistochemical evaluations, 48 cases of orbital lymphoid infiltrate disorders were examined for immunoglobulin heavy (IgH) gene rearrangement by means of PCR to amplify the FR3 region with formalin-fixed and paraffin-embedded tissues.Results: Gene rearrangement in the third frame-work of the IgH region was detected in specimens obtained from 15 cases of malignant lymphoma, 4 of reactive lymphoid hyperplasia and 3 of orbital pseudotumor. All of these patients showed a discrete band (100bp) which reflected monoclonal proliferation of B lymphocytes. 5 cases of malignant lymphoma, 6 of reactive lymphoid hyperplasia and 15 of orbital pseudotumor did not show a discrete band on PCR.Conclusions:     

Gene Rearrangement Analysis of Orbital Lymphoid Infilktrating Disorders

Purpose:To determine whether the use of polymerae chain reaction for B-cell gene rearrangement in patients with orbital lymphoid infiltrate disorders could be useful in the diagnosis of lymphoma,especially,in differentiating benign lesion from malignant one.Methoids:In addition to clinical,pathological,and immunohistochemical evaluatons,48 cases of orbital lymphoid infiltrate disorders were examined for immunoglobulin heavy (IgH) gene rearrangement by means of PCR to amplify the FR3 region with formalin-fixed and paraffin-embedded tissues.Results:Gene rearrangement in the third frame-work of the IgH region was detected in specimens obtained from 15 cases of malignant lymphoma,4 of reactive lymphoid hyperplasia and 3 of orbital pseudotumor.All of these patients showed a discrete band (100bp) which reflected monoclonal proliferation of B lymphocytes.5 cases of malignant lymphoma,6 of reactive lymphoid hyperplasia and 15 of orbital pseudotumor did not show a discrete band on PCR.Conclusions:The FR3 region gene rearrangement of Ig heavy in patients with orbital lymphoid infilktrate disorders may be an additional diagnostic tool in differentiating benign from malignant lymphoid diseases and in offering a useful adjunct for diagnosis in difficult or unclear case.It is a reliable and practical method of gene diagnosis in orbital lymphoid infiltrate disorders and helps to identife the molecular mechanism of malignant lymphoma.Eye Science 2000;16:15-21.     

Novel therapeutic option for orbital atypical lymphoid hyperplasia

Ocular lymphoid tumours represent a spectrum of lymphoproliferative disease and can be subdivided into benign or reactive lymphoid hyperplasia, indeterminate or atypical lymphoid proliferations and malignant lymphoma. Treatment options include a wait and watch approach, systemic steroids, local radiotherapy or systemic chemotherapy. We describe a case of bilateral atypical lymphoid hyperplasia treated successfully with combination immunotherapy and radiotherapy. A 60‐year‐old lady presented with proptosis and left supra‐orbital mass and was diagnosed to have bilateral atypical lymphoid hyperplasia. She had extensive extraocular facial infiltrates but no other sites of involvement on staging investigations. She was treated with eight doses of rituximab 375 mg/m² at weekly intervals with a good partial response, followed by consolidative radiotherapy. Rituximab may be an effective treatment adjunct/alternative for patients with atypical lymphoid hyperplasia of the orbit, particularly where widespread lesions preclude the use of initial radiotherapy.