Intraocular lymphoma: update on diagnosis and management.
Intraocular lymphoma: update on diagnosis and management.
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DOI：
10.1177/107327480401100502
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发表时间：
2004-09
期刊：
影响因子：
--
通讯作者：
C. Chan;Dana J. Wallace
中科院分区：
文献类型：
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作者：
C. Chan;Dana J. Wallace
背景原发性眼内淋巴瘤(PIOL)是原发性中枢神经系统淋巴瘤(PCNSL)的一个亚型，淋巴瘤细胞最初侵袭视网膜、玻璃体或视神经头，伴或不伴中枢神经系统受累。这种以前很少见的疾病的发病率急剧增加。鉴于其非特异性的表现和侵袭性的过程，PIOL提供了诊断和治疗的挑战。方法回顾目前PIOL的诊断和治疗策略，介绍我们在PIOL治疗中的经验。结果免疫组织化学、流式细胞术、细胞因子检测和分子分析等技术在PIOL诊断中的应用取得了新的进展。然而，明确的诊断仍然需要采集组织进行组织病理学检查。PIOL的最佳治疗方案尚不清楚。最初的治疗方案应该包括以甲氨蝶呤为基础的化疗和脑和眼睛的放射治疗。此外，玻璃体内注射甲氨蝶呤和自体干细胞移植治疗复发和难治性疾病也取得了令人振奋的结果。结论进一步确定PIOL的免疫表型和分子特征将继续有助于PIOL的诊断。未来的研究需要确定放射治疗的作用以及最佳的局部和全身化疗方案。
BACKGROUND Primary intraocular lymphoma (PIOL) is a subset of primary central nervous system lymphoma (PCNSL) in which lymphoma cells initially invade the retina, vitreous, or optic nerve head, with or without concomitant CNS involvement. The incidence of this previously rare condition has increased dramatically. Given its nonspecific presentation and aggressive course, PIOL provides a diagnostic and therapeutic challenge. METHODS We review the current strategies for diagnosis and treatment of PIOL and present our own experience with PIOL. RESULTS Recent developments in the diagnosis of PIOL include immunohistochemistry, flow cytometry, cytokine evaluation, and molecular analysis. However, definitive diagnosis still requires harvesting of tissue for histopathology. Optimal treatment for PIOL remains unclear. Initial therapeutic regimens should include methotrexate-based chemotherapy and radiotherapy to the brain and eye. In addition, promising results have been seen with intravitreal methotrexate and autologous stem cell transplantation for recurrent and refractory disease. CONCLUSIONS Efforts to further determine the immunophenotype and molecular characteristics of PIOL will continue to assist in the diagnosis of PIOL. Future studies are required to determine the role of radiotherapy and optimal local and systemic chemotherapeutic regimens.