Establishment of a combination scoring method for diagnosis of ocular adnexal lymphoproliferative disease.

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 t...

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Main Authors: Xiao-Li Qu, Yan Hei, Li Kang, Xin-Ji Yang, Yi Wang, Xiao-Zhong Lu, Li-Hua Xiao, Guang Yang
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2017-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0160175&type=printable
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author Xiao-Li Qu
Yan Hei
Li Kang
Xin-Ji Yang
Yi Wang
Xiao-Zhong Lu
Li-Hua Xiao
Guang Yang
author_facet Xiao-Li Qu
Yan Hei
Li Kang
Xin-Ji Yang
Yi Wang
Xiao-Zhong Lu
Li-Hua Xiao
Guang Yang
author_sort Xiao-Li Qu
collection DOAJ
description 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.
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spelling doaj-art-df75b39acf524286aabcf9825137e91c2025-08-20T02:45:28ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01125e016017510.1371/journal.pone.0160175Establishment of a combination scoring method for diagnosis of ocular adnexal lymphoproliferative disease.Xiao-Li QuYan HeiLi KangXin-Ji YangYi WangXiao-Zhong LuLi-Hua XiaoGuang YangLymphoproliferative 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.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0160175&type=printable
spellingShingle Xiao-Li Qu
Yan Hei
Li Kang
Xin-Ji Yang
Yi Wang
Xiao-Zhong Lu
Li-Hua Xiao
Guang Yang
Establishment of a combination scoring method for diagnosis of ocular adnexal lymphoproliferative disease.
PLoS ONE
title Establishment of a combination scoring method for diagnosis of ocular adnexal lymphoproliferative disease.
title_full Establishment of a combination scoring method for diagnosis of ocular adnexal lymphoproliferative disease.
title_fullStr Establishment of a combination scoring method for diagnosis of ocular adnexal lymphoproliferative disease.
title_full_unstemmed Establishment of a combination scoring method for diagnosis of ocular adnexal lymphoproliferative disease.
title_short Establishment of a combination scoring method for diagnosis of ocular adnexal lymphoproliferative disease.
title_sort establishment of a combination scoring method for diagnosis of ocular adnexal lymphoproliferative disease
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0160175&type=printable
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