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January 1982, Vol 100, No. 1 >
ARTICLE | January 1982

Ocular Adnexal Lymphoid Tumors: Title and subTitle BreakCorrelative Ultrastructural and Immunologic Marker Studies FREE

Frederick A. Jakobiec, MD; Takeo Iwamoto, MD; Daniel M. Knowles, II, MD
[+] Author Affiliations

Accepted for publication March 18, 1981.

Reprint requests to the Manhattan Eye, Ear, and Throat Hospital, 210 E 64th St, New York, NY 10021 (Dr Jakobiec).


Arch Ophthalmol. 1982;100(1):84-98. doi:10.1001/archopht.1982.01030030086007
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• Twenty-two ocular adnexal lymphoid infiltrates were analyzed by electron microscopy as well as immunologically and cytochemically. Five reactive polyclonal lesions were found to be preponderantly composed of small mature lymphocytes (presumably T cells) with clumped nuclear chromatin, sparse cytoplasmic organelles, and numerous monoribosomes. In 11 monoclonal B-cell lesions, both the 1-μm plastic sections examined by light microscopy and the electron micrographs disclosed immature cells, with more dispersed nuclear chromatin, prominent nucleoli, abundant cytoplasmic polyribosomes, and increased numbers of mitochondria and strands of endoplasmic reticulum (particularly in plasmacytoid lesions). The remaining six monoclonal B-cell lesions were composed of comparatively well-differentiated cells requiring electron microscopy to show somewhat more prominent nucleoli, slightly less dense clumping of the nuclear chromatin, increased numbers of mitochondria and short segments of rough-surfaced endoplasmic reticulum, and monoribosomes rather than polyribosomes. The importance of distinguishing this group of well-differentiated monoclonal lesions from the less well-differentiated ones was underscored by the results of the follow-up examinations, in that no evidence of extraorbital disease has been discovered in the former group, while a 50% incidence occurred in the latter.

REFERENCES

1 +
Morgan G:  Lymphocytic tumors of the orbit , in Bleeker GM, Garston JB, Kronenberg B, et al (eds): Orbital Disorders , vol 14, in Streife EB (series ed): Modern Problems in Ophthalmology. Basel, Switzerland, S Karger AG, 1975;, pp 355-360.
2 +
Morgan G, Harry J:  Lymphocytic tumors of indeterminate nature: A five year follow-up of 98 conjunctival and orbital lesions . Br J Ophthalmol 1978;;62:381-383.
3 +
Jakobiec FA, Jones IS:  Lymphomatous, plasmacytic, histiocytic and hematopoietic tumors , in Jakobiec FA, Jones IS (eds): Diseases of the Orbit . New York, Harper & Row Publishers Inc, 1979;, pp 309-353.
4 +
Sigelman J, Jakobiec FA:  Lymphoid lesions of the conjunctiva: Relation of histopathology to clinical outcome . Ophthalmology 1978;;85:818-843.
5 +
Knowles DM II, Jakobiec FA:  Orbital lymphoid neoplasms: Clinical, pathologic and immunologic characteristics , in Jakobiec FA (ed): Ocular and Adnexal Tumors . Birmingham, Ala, Aesculapius Publishing Co, 1978;, pp 806-838.
6 +
Jakobiec FA, McLean I, Font RL:  Clinicopathologic characteristics of orbital lymphoid hyperplasia . Ophthalmology 1979;;86:48-66.
7 +
Knowles DM II, Jakobiec FA:  Orbital lymphoid neoplasms: A clinicopathologic study of 60 patients . Cancer 1980;;46:576-589.
8 +
Knowles DM II, Jakobiec FA, Halper JP:  Immunologic characterization of ocular adnexal lymphoid neoplasms . Am J Ophthalmol 1979;;87:603-619.
9 +
Knowles DM II, Halper JA, Trokel S, et al:  Immunofluorescent and immunoperoxidase characteristics of IgDλ myeloma involving the orbit . Am J Ophthalmol 1978;;85:485-494.
10 +
Knowles DM II, Jakobiec FA:  Quantitative determination of T cells in ocular lymphoid infiltrates: An indirect method for distinguishing between pseudolymphoma and malignant lymphoma . Arch Ophthalmol 1981;;99:309-316.
11 +
Iwamoto T, Jones IS, Howard G:  Ultrastructural comparison of spindle A, spindle B, and epithelioid type cells in uveal malignant melanoma . Invest Ophthalmol Vis Sci 1972;; 11:873-889.
12 +
Knowles DM II, Jakobiec FA: Ocular adnexal lymphoid neoplasms: Clinical histopathologic, immunologic, and electron microscopic characterization. Hum Pathol, to be published.
13 +
Levine GD, Dorfman RF:  Nodular lymphoma: An ultrastructural study of its relationship to germinal centers and a correlation of light and electron microscopic findings . Cancer 1975;; 35:148-164.
14 +
Rilke F, Pilotti S, Carbone A, et al:  Morphology of lymphatic cells and of their derived tumors . J Clin Pathol 1978;;31:1009-1056.
15 +
Said J, Hargreaves H, Pinkus G:  Non-Hodgkin's lymphomas: An ultrastructural study correlating morphology with immunologic cell type . Cancer 1979;;44:504-528.
16 +
Zucker-Franklin D, Melton JW, Quagliata F:  Ultrastructural, immunologic and functional studies on Sezary cells: A neoplastic variant of thymus-derived (T) lymphocytes . Proc Natl Acad Sci USA 1974;;71:1877-1881.
17 +
Rosas-Uribe A, Variakojis D, Molnar Z, et al:  Mycosis fungoides: An ultrastructural study . Cancer 1974;;34:634-645.
18 +
Ding JC, Adams PB, Patison M, et al:  Thymic origin of abnormal lymphoid cells in Sezary syndrome . Cancer 1975;;35:1325-1332.
19 +
Robinowitz BN, Noguchi S, Roenigk HH:  Tumor cell characterization in mycosis fungoides . Cancer 1976;;37:1747-1753.
20 +
Stenson S, Ramsay D:  Ocular findings in mycosis fungoides . Arch Ophthalmol 1981;;99:272-277.
21 +
Fratkin JD, Shammas HF, Miller SD:  Disseminated Hodgkin's disease with bilateral orbital involvement . Arch Ophthalmol 1978;;96:102-104.
22 +
Nanba K, Jaffe FS, Braylan RC, et al:  Alkaline phosphatase-positive malignant lymphoma: A subtype of B cell lymphomas . Am J Clin Pathol 1977;;68:535-542.
23 +
Mann RB, Jaffe ES, Berard CW:  Malignant lymphomas: A conceptual understanding of morphologic diversity . Am J Pathol 1979;;94:105-175.
24 +
Berard CW, Jaffe ES, Braylan RC, et al:  Immunologic aspects and pathology of the malignant lymphomas . Cancer 1978;;42:911-921.
25 +
Waldron JA, Leech JH, Glick AD, et al:  Malignant lymphoma of peripheral T lymphocyte origin . Cancer 1977;;40:1604-1617.
26 +
Palutke J, Patt DJ, Weise R, et al:  T cell leukemia-lymphoma in young adults . Am J Clin Pathol 1977;;68:429-439.
27 +
Rosen PJ, Feinstein DI, Bonorris JM, et al:  Convoluted lymphocytic (T cell) lymphoma: A distinct clinical-pathologic entity . Blood 1972;; 46:1015.
28 +
Jakobiec FA, Mottow LS:  Pediatric orbital pseudotumor , in Jakobiec FA (ed): Ocular and Adnexal Tumors . Birmingham, Ala, Aesculapius Publishing Co, 1978;, pp 644-658.
29 +
Mottow LS, Jakobiec FA:  Idiopathic inflammatory orbital pseudotumor in childhood: I. Clinical characteristics . Arch Ophthalmol 1978;;96:1410-1417.
30 +
Mottow-Lippa L, Jakobiec FA, Smith M:  Idiopathic inflammatory orbital pseudotumor in childhood: II. Results of diagnostic tests and biopsies . Ophthalmology 1981;;88:565-574.
31 +
Jakobiec FA, Gibralter R, Knowles DM II, et al:  Lymphoid tumor of the lid . Ophthalmology 1980;;87:1058-1064.
32 +
Arno J: Atlas of Lymph Node Pathology . Philadelphia, JB Lippincott Co, 1980;, p 69.
33 +
Kim H, Jacobs C, Warnke RA, et al:  Malignant lymphomas with a high content of epithelioid histiocytes: A distinct clinicopathologic entity and a form of so-called `Lennert's lymphoma.' Cancer 1978;;41:620-635.
34 +
Lennert K, Mohri N, Stein H, et al:  The histopathology of malignant lymphoma . Br J Haematol 1975;;31( (suppl) ):193-203.
35 +
Pangalis GA, Nathwani BN, Rappaport H:  Malignant lymphoma, well differentiated lymphocytic: Its relationship with chronic lymphocytic leukemia and macroglobulinema of Waldenström . Cancer 1977;;39:999-1010.
36 +
Nadler LM, Stashenko P, Hardy R, et al:  A monoclonal antibody defining a lymphoma-associated antigen in man . J Immunol 1980;;125:570-577.
37 +
Reinherz E, Schlossman S:  Regulation of the immunologic response: Inducer and suppressor T lymphocytic subsets in human beings . N Engl J Med 1980;;303:370-373.

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1 +
Morgan G:  Lymphocytic tumors of the orbit , in Bleeker GM, Garston JB, Kronenberg B, et al (eds): Orbital Disorders , vol 14, in Streife EB (series ed): Modern Problems in Ophthalmology. Basel, Switzerland, S Karger AG, 1975;, pp 355-360.
2 +
Morgan G, Harry J:  Lymphocytic tumors of indeterminate nature: A five year follow-up of 98 conjunctival and orbital lesions . Br J Ophthalmol 1978;;62:381-383.
3 +
Jakobiec FA, Jones IS:  Lymphomatous, plasmacytic, histiocytic and hematopoietic tumors , in Jakobiec FA, Jones IS (eds): Diseases of the Orbit . New York, Harper & Row Publishers Inc, 1979;, pp 309-353.
4 +
Sigelman J, Jakobiec FA:  Lymphoid lesions of the conjunctiva: Relation of histopathology to clinical outcome . Ophthalmology 1978;;85:818-843.
5 +
Knowles DM II, Jakobiec FA:  Orbital lymphoid neoplasms: Clinical, pathologic and immunologic characteristics , in Jakobiec FA (ed): Ocular and Adnexal Tumors . Birmingham, Ala, Aesculapius Publishing Co, 1978;, pp 806-838.
6 +
Jakobiec FA, McLean I, Font RL:  Clinicopathologic characteristics of orbital lymphoid hyperplasia . Ophthalmology 1979;;86:48-66.
7 +
Knowles DM II, Jakobiec FA:  Orbital lymphoid neoplasms: A clinicopathologic study of 60 patients . Cancer 1980;;46:576-589.
8 +
Knowles DM II, Jakobiec FA, Halper JP:  Immunologic characterization of ocular adnexal lymphoid neoplasms . Am J Ophthalmol 1979;;87:603-619.
9 +
Knowles DM II, Halper JA, Trokel S, et al:  Immunofluorescent and immunoperoxidase characteristics of IgDλ myeloma involving the orbit . Am J Ophthalmol 1978;;85:485-494.
10 +
Knowles DM II, Jakobiec FA:  Quantitative determination of T cells in ocular lymphoid infiltrates: An indirect method for distinguishing between pseudolymphoma and malignant lymphoma . Arch Ophthalmol 1981;;99:309-316.
11 +
Iwamoto T, Jones IS, Howard G:  Ultrastructural comparison of spindle A, spindle B, and epithelioid type cells in uveal malignant melanoma . Invest Ophthalmol Vis Sci 1972;; 11:873-889.
12 +
Knowles DM II, Jakobiec FA: Ocular adnexal lymphoid neoplasms: Clinical histopathologic, immunologic, and electron microscopic characterization. Hum Pathol, to be published.
13 +
Levine GD, Dorfman RF:  Nodular lymphoma: An ultrastructural study of its relationship to germinal centers and a correlation of light and electron microscopic findings . Cancer 1975;; 35:148-164.
14 +
Rilke F, Pilotti S, Carbone A, et al:  Morphology of lymphatic cells and of their derived tumors . J Clin Pathol 1978;;31:1009-1056.
15 +
Said J, Hargreaves H, Pinkus G:  Non-Hodgkin's lymphomas: An ultrastructural study correlating morphology with immunologic cell type . Cancer 1979;;44:504-528.
16 +
Zucker-Franklin D, Melton JW, Quagliata F:  Ultrastructural, immunologic and functional studies on Sezary cells: A neoplastic variant of thymus-derived (T) lymphocytes . Proc Natl Acad Sci USA 1974;;71:1877-1881.
17 +
Rosas-Uribe A, Variakojis D, Molnar Z, et al:  Mycosis fungoides: An ultrastructural study . Cancer 1974;;34:634-645.
18 +
Ding JC, Adams PB, Patison M, et al:  Thymic origin of abnormal lymphoid cells in Sezary syndrome . Cancer 1975;;35:1325-1332.
19 +
Robinowitz BN, Noguchi S, Roenigk HH:  Tumor cell characterization in mycosis fungoides . Cancer 1976;;37:1747-1753.
20 +
Stenson S, Ramsay D:  Ocular findings in mycosis fungoides . Arch Ophthalmol 1981;;99:272-277.
21 +
Fratkin JD, Shammas HF, Miller SD:  Disseminated Hodgkin's disease with bilateral orbital involvement . Arch Ophthalmol 1978;;96:102-104.
22 +
Nanba K, Jaffe FS, Braylan RC, et al:  Alkaline phosphatase-positive malignant lymphoma: A subtype of B cell lymphomas . Am J Clin Pathol 1977;;68:535-542.
23 +
Mann RB, Jaffe ES, Berard CW:  Malignant lymphomas: A conceptual understanding of morphologic diversity . Am J Pathol 1979;;94:105-175.
24 +
Berard CW, Jaffe ES, Braylan RC, et al:  Immunologic aspects and pathology of the malignant lymphomas . Cancer 1978;;42:911-921.
25 +
Waldron JA, Leech JH, Glick AD, et al:  Malignant lymphoma of peripheral T lymphocyte origin . Cancer 1977;;40:1604-1617.
26 +
Palutke J, Patt DJ, Weise R, et al:  T cell leukemia-lymphoma in young adults . Am J Clin Pathol 1977;;68:429-439.
27 +
Rosen PJ, Feinstein DI, Bonorris JM, et al:  Convoluted lymphocytic (T cell) lymphoma: A distinct clinical-pathologic entity . Blood 1972;; 46:1015.
28 +
Jakobiec FA, Mottow LS:  Pediatric orbital pseudotumor , in Jakobiec FA (ed): Ocular and Adnexal Tumors . Birmingham, Ala, Aesculapius Publishing Co, 1978;, pp 644-658.
29 +
Mottow LS, Jakobiec FA:  Idiopathic inflammatory orbital pseudotumor in childhood: I. Clinical characteristics . Arch Ophthalmol 1978;;96:1410-1417.
30 +
Mottow-Lippa L, Jakobiec FA, Smith M:  Idiopathic inflammatory orbital pseudotumor in childhood: II. Results of diagnostic tests and biopsies . Ophthalmology 1981;;88:565-574.
31 +
Jakobiec FA, Gibralter R, Knowles DM II, et al:  Lymphoid tumor of the lid . Ophthalmology 1980;;87:1058-1064.
32 +
Arno J: Atlas of Lymph Node Pathology . Philadelphia, JB Lippincott Co, 1980;, p 69.
33 +
Kim H, Jacobs C, Warnke RA, et al:  Malignant lymphomas with a high content of epithelioid histiocytes: A distinct clinicopathologic entity and a form of so-called `Lennert's lymphoma.' Cancer 1978;;41:620-635.
34 +
Lennert K, Mohri N, Stein H, et al:  The histopathology of malignant lymphoma . Br J Haematol 1975;;31( (suppl) ):193-203.
35 +
Pangalis GA, Nathwani BN, Rappaport H:  Malignant lymphoma, well differentiated lymphocytic: Its relationship with chronic lymphocytic leukemia and macroglobulinema of Waldenström . Cancer 1977;;39:999-1010.
36 +
Nadler LM, Stashenko P, Hardy R, et al:  A monoclonal antibody defining a lymphoma-associated antigen in man . J Immunol 1980;;125:570-577.
37 +
Reinherz E, Schlossman S:  Regulation of the immunologic response: Inducer and suppressor T lymphocytic subsets in human beings . N Engl J Med 1980;;303:370-373.

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