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Ocular Adnexal MALT Lymphoma : Prognosis

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HemePath_MALToma_Conjunctiva7.jpg

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Ocular adnexal MALT lymphomas have an excellent prognosis. Almost 80% are localized (Stage IE) at presentation and can be treated with low-dose external beam radiation, surgery, or cryotherapy. More recently, intralesional interferon and systemic rituximab (anti-CD20 antibody) have been utilized. Cases associated with Chlamydia psittaci show partial or complete remission with antibiotic therapy.

If a systemic component is present (<20% of cases), patient is usually given combination chemotherapy. Almost 95% of cases achieve remission and overall 5-year survival is 90%. Recurrence or disease progression is seen in about 40% of primary conjunctival lymphomas and can involve lymph nodes, the opposite orbit, or extranodal sites.

This image from a primary MALT lymphoma of the conjunctiva shows medium-sized marginal zone B-cells with moderate to abundant pale cytoplasm and slightly irregular medium-sized nuclei.

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