• Lymphoma of the Eyelid: An International Multicenter Retrospective Study

    By Lynda Seminara and selected by Richard K. Parrish II, MD

    Journal Highlights

    American Journal of Ophthalmology, May 2017

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    Svendsen et al. conducted a multicenter observational study to examine subtype-specific clinical features of eyelid lymphoma and determine their effect on survival outcomes. The authors identified 5 main subtypes and found prognosis to be significantly better for 3 of them: extranodal marginal-zone lymphoma (EMZL), follicular lymphoma (FL), and mycosis fungoides (MF). Survival rates were poorer for diffuse large B-cell lymphoma (DLBCL) and mantle cell lymphoma (MCL).

    Data for 86 patients with primary or secondary lymphoma of the eyelid were collected from 7 international eye cancer centers. A primary outcome measure was 5-year disease-specific survival (DSS) rates.

    Non-Hodgkin B-cell lymphoma was present in 72 patients; T-cell lymphoma occurred in 15 patients. The most common subtypes were EMZL (n = 32), FL (n = 20), DLCBL (n = 9), MCL (n = 7), and MF (n = 8). EMZL had a female predilection, whereas MCL and MF were more common among males. MCL, DLBCL, and MF often were secondary lymphomas. The median duration of symptoms prior to diagnosis was longer for low-grade EMZL and FL (8 and 5 months, respectively) than for high-grade DLBCL (1 month). Orbital spread occurred more frequently in B-cell lymphomas, a finding noted previously.

    Localized EMZL and FL generally were treated with external beam radi­ation therapy. Chemotherapy was commonly used for DLBCL, MCL, and high Ann Arbor stage EMZL and FL. Prognosis was poor for DLBCL and MCL (5-year DSS: 21% and 50%, respectively) but favorable for EMZL, FL, and MF (5-year DSS: 88%, 88%, and 86%, respectively). Patients with primary lymphoma had a significantly better 5-year DSS rate than those with secondary lymphoma (85% vs. 64%).

    The authors concluded that histologic subtype was the predominant predictor of prognosis, which was significantly better for patients with subtypes EMZL, FL, and MF. It may be helpful to incorporate this information into cancer staging systems.

    The original article can be found here.