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Establishment of a combination scoring method for diagnosis of ocular adnexal lymphoproliferative disease
- Source :
- PLoS ONE, Vol 12, Iss 5, p e0160175 (2017), PLoS ONE
- Publication Year :
- 2017
- Publisher :
- Public Library of Science (PLoS), 2017.
-
Abstract
- Lymphoproliferative diseases (LPDs) of the ocular adnexa encompass the majority of orbital diseases and include reactive follicular hyperplasia (RFH), atypical lymphoid hyperplasia (ALH), and mucosa-associated lymphoid tissue lymphoma (MALToma). Lymphoid follicles (LFs) are usually observed during the histological examination of LPDs. Currently, because there is a lack of specific clinical signs and diagnostic immunohistochemical biomarkers, it is difficult for pathologists to distinguish MALToma from ocular RFH and ALH, which makes the clinical management of these conditions difficult. Here, we analyzed the clinical features of patients with ocular adnexal LPDs (n = 125) and investigated the structure of LFs in paraffin-embedded tissue samples using anti-CD23 and anti-IgD immunochemistry. We found that some clinical features including age, sex, and laterality were different among RFH, LFH, and MALToma. Additionally, immunohistochemistry revealed that the expression of IgD and CD23 was higher in RFH patients and decreased in patients with ALH and MALToma. Moreover, LFs in RFH were intact, whereas the structures of most LFs were disrupted in ALH. In MALToma specimens, few intact LFs were observed. In a further investigation, we combined the results for CD23/IgD immunohistochemistry and the structure of LFs to establish a scoring method for the differential diagnosis of LPDs. According to the BIOMED-2 protocol, we further detected IgH gene monoclonal rearrangement in 73 cases (35 RFH, 17 ALH, and 21 MALToma cases). The sensitivity of our scoring method, based on a comparison with the results of IgH gene monoclonal rearrangement detection, was 85.7% (18/21) for MALToma and 35.3% (6/17) for ALH. Our study provides a method that may be useful for the differential diagnosis of RFH, ALH, and MALToma.
- Subjects :
- Male
0301 basic medicine
Pathology
B Cells
Gene Expression
lcsh:Medicine
Immunostaining
Immunoglobulin D
Hematologic Cancers and Related Disorders
White Blood Cells
0302 clinical medicine
Animal Cells
Medicine and Health Sciences
lcsh:Science
Staining
Aged, 80 and over
Gene Rearrangement
Multidisciplinary
music.instrument
biology
Ocular Tumors
Hematology
Middle Aged
Immunohistochemistry
Follicular hyperplasia
Phenotype
Lymphatic system
Oncology
030220 oncology & carcinogenesis
Monoclonal
Lymphomas
Female
Anatomy
Cellular Types
Immunoglobulin Heavy Chains
Research Article
Adult
medicine.medical_specialty
Adolescent
Ocular Anatomy
Immune Cells
Immunology
Research and Analysis Methods
Clonal Evolution
Diagnosis, Differential
Young Adult
03 medical and health sciences
Ocular System
Diagnostic Medicine
Cancer Detection and Diagnosis
medicine
Humans
Antibody-Producing Cells
music
Aged
Blood Cells
Receptors, IgE
business.industry
Eye Neoplasms
lcsh:R
Biology and Life Sciences
Cancers and Neoplasms
Cell Biology
Gene rearrangement
medicine.disease
Lymphoproliferative Disorders
Lymphoma
Ophthalmology
030104 developmental biology
Specimen Preparation and Treatment
biology.protein
lcsh:Q
Differential diagnosis
business
Biomarkers
Subjects
Details
- ISSN :
- 19326203
- Volume :
- 12
- Database :
- OpenAIRE
- Journal :
- PLOS ONE
- Accession number :
- edsair.doi.dedup.....939a8db44a8c0ee80025ac3da6b5a612