RESUMO
Evidence from certain geographical areas links lymphomas of the ocular adnexa marginal zone B-cell lymphomas (OAMZL) with Chlamydophila psittaci (Cp) infection, suggesting that lymphoma development is dependent upon chronic stimulation by persistent infections. Notwithstanding that, the actual immunopathogenetical mechanisms have not yet been elucidated. As in other B-cell lymphomas, insight into this issue, especially with regard to potential selecting ligands, could be provided by analysis of the immunoglobulin (IG) receptors of the malignant clones. To this end, we studied the molecular features of IGs in 44 patients with OAMZL (40% Cp-positive), identifying features suggestive of a pathogenic mechanism of autoreactivity. Herein, we show that lymphoma cells express a distinctive IG repertoire, with electropositive antigen (Ag)-binding sites, reminiscent of autoantibodies (auto-Abs) recognizing DNA. Additionally, five (11%) cases of OAMZL expressed IGs homologous with autoreactive Abs or IGs of patients with chronic lymphocytic leukemia, a disease known for the expression of autoreactive IGs by neoplastic cells. In contrast, no similarity with known anti-Chlamydophila Abs was found. Taken together, these results strongly indicate that OAMZL may originate from B cells selected for their capability to bind Ags and, in particular, auto-Ags. In OAMZL associated with Cp infection, the pathogen likely acts indirectly on the malignant B cells, promoting the development of an inflammatory milieu, where auto-Ags could be exposed and presented, driving proliferation and expansion of self-reactive B cells.
Assuntos
Autoantígenos/imunologia , Neoplasias Oculares/imunologia , Genes de Imunoglobulinas , Linfoma de Zona Marginal Tipo Células B/imunologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise por Conglomerados , Regiões Determinantes de Complementaridade , Neoplasias Oculares/etiologia , Feminino , Humanos , Cadeias Pesadas de Imunoglobulinas/genética , Região Variável de Imunoglobulina/genética , Ativação Linfocitária , Linfoma de Zona Marginal Tipo Células B/etiologia , Masculino , Pessoa de Meia-Idade , Psitacose/complicaçõesRESUMO
An orbital abscess is an ophthalmic surgical emergency that is typically caused by the spread of bacteria from adjacent structures, such as the sinuses, eyelids, or teeth. Although acute dacryocystitis is commonly associated with preseptal cellulitis, it rarely causes orbital infection. Infection of the lacrimal sac will typically localize in the preseptal space because the lacrimal sac lies anterior to the orbital septum. To the authors' knowledge, this is the first report of an intraconal abscess secondary to acute dacryocystitis. The key points in the surgical management of this entity are discussed.
Assuntos
Abscesso/microbiologia , Dacriocistite/complicações , Infecções Oculares Bacterianas/etiologia , Doenças Orbitárias/microbiologia , Abscesso/diagnóstico , Abscesso/terapia , Doença Aguda , Adulto , Antibacterianos , Bactérias/isolamento & purificação , Terapia Combinada , Dacriocistite/diagnóstico , Dacriocistite/terapia , Dacriocistorinostomia , Quimioterapia Combinada/uso terapêutico , Infecções Oculares Bacterianas/diagnóstico , Infecções Oculares Bacterianas/terapia , Seguimentos , Humanos , Aparelho Lacrimal/microbiologia , Aparelho Lacrimal/patologia , Aparelho Lacrimal/cirurgia , Imageamento por Ressonância Magnética , Masculino , Doenças Orbitárias/diagnóstico , Acuidade VisualRESUMO
The clinical, radiological and histopathological findings in an 81-year-old man presenting with lung carcinoma metastatic to the orbit are described. Orbital biopsy was complicated by postoperative visual loss and failed to contribute significantly to the final diagnosis. The authors believe that in cases of possible orbital metastases a primary neoplasm should be excluded by means of a complete oncological assessment before proceeding to biopsy.