PDF(Pubmed)
Abstract：
A 63-year-old woman, with 11-year history of breast cancer, showed bilateral lacrimal gland enlargement on magnetic resonance imaging. Gallium-67 scintigraphy, as the standard at that time in 2004, demonstrated abnormally high uptake only in bilateral lacrimal glands. The lacrimal glands were extirpated and the pathological diagnosis was mantle cell lymphoma (MCL). She underwent bilateral orbital radiation, based on no uptake of gallium-67 in other sites of the body. In a month, bone marrow biopsy revealed the infiltration with MCL, positive for cyclin D1. She showed hepatic lymphadenopathy and splenomegaly, and so received 2 cycles of alternating Hyper-CVAD therapy and high-dose methotrexate with cytarabine, combined with rituximab, in 2 months, leading to complete remission. She underwent autologous peripheral blood stem cell transplantation and was well until the age of 68 years when she showed a recurrent intratracheal submucosal lesion of lymphoma and underwent one course of reduced-dose CHOP combined with rituximab. Next year, the left rib resection revealed the metastasis of breast adenocarcinoma, leading to daily oral letrozole. Further 2 years later, computed tomographic scan demonstrated multiple submucosal nodular lesions in the trachea and bronchi, together with cervical and supraclavicular lymphadenopathy, and intratracheal lesion biopsy and bone marrow biopsy proved the involvement with MCL. She underwent 2 courses of bendamustine and rituximab, resulting in complete remission but died of metastatic breast cancer at the age of 74 years. Clinical features in 48 previous cases with ocular adnexal MCL in the literature were summarized in this study.
摘要：
一个63岁的女人,有11年的乳腺癌病史,磁共振成像显示双侧泪腺肿大。镓-67闪烁显像,作为当时2004年的标准，仅在双侧泪腺中显示异常高的摄取。泪腺切除，病理诊断为套细胞淋巴瘤（MCL）。她接受了双侧眼眶放射,基于在身体的其他部位没有吸收镓-67。一个月后,骨髓活检显示MCL浸润，细胞周期蛋白D1阳性。她表现为肝淋巴结肿大和脾肿大，因此接受了2个周期的交替的Hyper-CVAD治疗和大剂量甲氨蝶呤与阿糖胞苷，联合利妥昔单抗，在两个月内,导致完全缓解。她接受了自体外周血干细胞移植，直到68岁时才表现出淋巴瘤的气管内粘膜下复发性病变，并接受了一个疗程的减量CHOP联合利妥昔单抗。明年,左肋骨切除显示乳腺癌转移,导致每日口服来曲唑。再过两年,计算机断层扫描显示气管和支气管有多个粘膜下结节性病变，连同颈椎和锁骨上淋巴结病，气管内病变活检和骨髓活检证实MCL受累。她接受了2个疗程的苯达莫司汀和利妥昔单抗,导致完全缓解，但在74岁时死于转移性乳腺癌。本研究总结了文献中48例眼附属器MCL的临床特征。
