title: Clinical value of magnetic resonance imaging and other baseline testing for conjunctival mucosa-associated lymphoid tissue lymphoma.
abstract: Abstract The objective of this study was to assess the value of magnetic resonance imaging (MRI) of the orbit for conjunctival mucosa-associated lymphoid tissue (MALT) lymphoma. The yield of other staging tests at baseline were also evaluated. Twenty-one consecutive patients treated for conjunctival MALT lymphoma were retrospectively studied. Lymphoma was staged according to both the Ann Arbor system and the seventh edition of the AJCC [American Joint Committee on Cancer] cancer staging manual. Findings on MRI of the orbit, whole-body positron emission tomography/computed tomography (PET/CT), CT of the chest/abdomen/pelvis, bone marrow (BM) biopsy and gastrointestinal (GI) endoscopy were recorded. Seventeen patients had orbital MRI. Fourteen of 17 patients (82%) with obvious conjunctival MALT lymphoma on clinical examination had a negative MRI scan. Only three patients had subtle conjunctival enhancement on orbital MRI. Ann Arbor stage at presentation was as follows: stage IE (15 patients), stage IIE (two patients) and stage IV (four patients). Eighteen of 21 patients had total-body PET/CT; four patients (22%) had hypermetabolic activity evident on PET scan. All 21 patients had bilateral BM biopsies. Fifteen of 21 patients (71%) had GI endoscopy. None of the patients had a positive BM biopsy or findings on GI endoscopy. Our data suggest that orbital MRI has a very low yield for identification of conjunctival MALT lymphoma. Clinical examination is critical in diagnosing and assessing treatment response in conjunctival MALT lymphoma. The yield for GI endoscopy and BM biopsy may also be low in staging of conjunctival MALT lymphoma.
authors.affiliation: Orbital Oncology and Oculoplastic Surgery Program, Department of Plastic Surgery.
authors.forename: Qasiem J
authors.initials: QJ
authors.lastname: Nasser
authors.forename: Margaret L
authors.initials: ML
authors.lastname: Pfeiffer
authors.forename: Jorge
authors.initials: J
authors.lastname: Romaguera
authors.forename: Nathan
authors.initials: N
authors.lastname: Fowler
authors.forename: J Matthew
authors.initials: JM
authors.lastname: Debnam
authors.forename: Felipe
authors.initials: F
authors.lastname: Samaniego
authors.forename: Tarek
authors.initials: T
authors.lastname: El-Sawy
authors.forename: Peter
authors.initials: P
authors.lastname: McLaughlin
authors.forename: Mathieu F
authors.initials: MF
authors.lastname: Bakhoum
authors.forename: Bita
authors.initials: B
authors.lastname: Esmaeli
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D001853:Bone Marrow / Q000473:pathology; D003131:Combined Modality Therapy; D003228:Conjunctiva / Q000473:pathology*; D003955:Diagnostic Tests, Routine; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult