The tale and molecular trail of a disseminated ocular adnexal malt lymphoma.
OBJECTIVE
To report a case of a MALT lymphoma of the eyelid, which recurred in several sites over a time period of 14 years, and where the identical B-cell clone could be demonstrated in most samples using polymerase chain reaction (PCR) and GeneScan analysis.


METHODS
Clinical, histologic, immunohistochemical, PCR and GeneScan analysis findings are presented.


RESULTS
A 58-year-old woman presented with a swelling of the left lower lid. Excisional biopsy of the tumour revealed a low-grade malignant B-cell Non-Hodgkin lymphoma (NHL) of MALT type. Despite localized radiochemotherapy, the patient developed recurrences occurring in the pharynx, in the right orbit, in the skin of the right foot, and in the bone marrow 1, 7, 11 and 14 years, respectively, after establishment of the first diagnosis. PCR for a rearrangement of the immunoglobulin heavy chains (IgH) and GeneScan analysis of the samples produced amplificates identical in size at most sites, indicating derivation from the same B-cell clone.


CONCLUSIONS
It is generally assumed that ocular adnexal MALT lymphoma is associated with an indolent clinical course. Using IgH-PCR and GeneScan analysis, we demonstrate that the current case illustrates that these lymphomas do indeed require regular control examinations following treatment, as they often recur and disseminate in some patients in an unpredictable manner.
Coupland
Sarah E
SE
Department of Pathology, University of Liverpool, Liverpool, UK. s.e.coupland@liverpool.ac.uk
Jaehne
Doris
D
Hummel
Michael
M
Stein
Harald
H
D014408:Biomarkers, Tumor / Q000378:metabolism; D019046:Bone Marrow Neoplasms / Q000235:genetics / Q000378:metabolism / Q000473:pathology*; D005142:Eyelid Neoplasms / Q000235:genetics / Q000378:metabolism / Q000473:pathology*; D005260:Female; D015326:Gene Rearrangement, B-Lymphocyte, Heavy Chain / Q000235:genetics; D006801:Humans; D007124:Immunoenzyme Techniques; D007143:Immunoglobulin Heavy Chains / Q000235:genetics; D018442:Lymphoma, B-Cell, Marginal Zone / Q000235:genetics / Q000378:metabolism / Q000473:pathology*; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000235:genetics / Q000378:metabolism / Q000473:pathology*; D009364:Neoplasm Recurrence, Local; D016133:Polymerase Chain Reaction; D012878:Skin Neoplasms / Q000235:genetics / Q000378:metabolism / Q000473:pathology*
D014408:Biomarkers, Tumor; D007143:Immunoglobulin Heavy Chains