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International Journal of Advances In Case Reports

Volume 11, Issue 1, 2024
Mcmed International
International Journal of Advances In Case Reports
Issn
XXX-XXXX (Print), 2349 - 8005 (Online)
Frequency
bi-annual
Email
editorijacr@mcmed.us
Journal Home page
http://mcmed.us/about/ijacr
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Abstract
Title
DIFFERENTIAL DIAGNOSIS PITFALLS IN OCULAR ADNEXAL LYMPHOMA WITH ABERRANT PHENOTYPE AND ASSOCIATION WITH CHLAMYDOPHILA PSITTACI: CASE REPORT
Author
Chandra Chiappin Cardoso, Íris Mattos Santos, Thaís Mattos Santos, Gabriela Cristina Segat, Lee I-Ching, Giovanna Steffenello-Durigon, Maria Claudia Santos-Silva
Email
maria.claudia.silva@ufsc.br
keyword
Flow cytometry, Ocular adnexal lymphomas, MALT lymphoma, Follicular lymphoma, Chlamydophila psittaci.
Abstract
Ocular adnexal lymphomas (OAL) are a heterogeneous group of malignancies, making up approximately 1-2% of non-Hodgkin lymphomas. The most common subtype of primary OAL is MALT lymphoma, followed by follicular lymphoma. Small B-cell lymphomas share many similarities, especially among indolent lymphomas, in which aberrant and overlapping phenotypes often make defining the diagnosis difficult. In addition, since 2004, Chlamydophila psittaci (Cp) has been associated with ocular adnexal MALT-lymphoma. The aim of this study is to report a case of ocular adnexal lymphoma with Cp infection association, which illustrates a complex differential diagnosis. The biopsy of the eye lesion was morphologically and phenotypically analyzed. Eye swab and peripheral blood (PB) samples were analyzed by immunofluorescence and PCR in order to detect the presence of Cp. Histopathological and immunohistochemical analysis of the biopsy of the eye lesion revealed an atypical lymphocytic infiltrate CD20 and lambda positive. Multiparametric flow cytometry showed 54% of mature B lymphocytes with a kappa/lambda ratio equal to 0.46. Lambda B lymphocytes showed greater size, expression of CD19, bright CD20, and CD10. Cp DNA was detected in eye swab and PB samples by PCR. The elected treatment regimen was doxycycline along with radiotherapy sessions. The compilation of clinical information added to the results of histopathologic, phenotypic, and molecular exams indicated the diagnosis of ocular adnexal MALT-lymphoma with aberrant expression of CD10.
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