MALT lymphoma

MALT 淋巴瘤
  • 文章类型: Case Reports
    粘膜相关淋巴组织结外边缘区淋巴瘤(EMZL),也被称为MALT淋巴瘤,是一种结外多器官侵袭性增生性淋巴瘤,由形态可变的小B细胞组成。它最常见于消化道,胃部患病率很高,但起源于小肠的EMZL很少见,临床表现缺乏特异性,很容易被误诊.在这里,我们报告了一例罕见的小肠EMZL表现为肠套叠的病例,该病例为32岁男性.在当地医院进行的结肠镜检查发现一个大小约为5厘米×5厘米的带蒂息肉,表面粗糙,回盲区出现充血。他被送进我们医院做息肉切除手术。对比增强计算机断层扫描(CT)扫描提示回肠肠套叠,随后在我们医院的结肠镜检查证实了这一点。成人肠套叠相对罕见,90%的病例具有已知的致病机制,40%的病例由原发性或继发性恶性肿瘤引起。因此,我们对患者进行了腹腔镜辅助右半结肠切除术.切除的标本显示回肠末端肠套叠进入升结肠,肠套叠为充血和水肿。肠套叠结束时可见2.5cm×2.5cm×1.5cm肿块。术后病理显示肿块为EMZL,部分转化为大B细胞淋巴瘤。患者转入血液科,完成PET-CT显示原发性肠淋巴瘤的术后表现,卢加诺上演IE2。尽管EMZL是一种惰性淋巴瘤,患者处于早期阶段,利妥昔单抗,环磷酰胺,阿霉素,长春新碱,鉴于组织学转变,给予泼尼松(R-CHOP)方案。患者正在定期随访。这是一例罕见的由于EMZL引起的小肠肿块,在成人中表现为肠套叠,强调了腹腔镜辅助肠切除术是小肠EMZL多学科协作治疗的潜在治疗方法。
    Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (EMZL), also known as MALT lymphoma, is an extranodal multiorgan-invasive proliferative lymphoma composed of small B cells with variable morphology. It most commonly occurs in the digestive tract, with a high prevalence in the stomach, but EMZL originating in the small intestine is rare and lacks specificity in clinical manifestations, which makes it easy to be misdiagnosed. Herein, we report a rare case of small intestinal EMZL presentation as intussusception in a 32-year-old man. A colonoscopy performed at the local hospital revealed a pedicled polyp about 5 cm × 5 cm in size with a rough surface, and hyperemia was seen in the ileocecal region. He was admitted to our hospital for a polypectomy. A contrast-enhanced computed tomographic (CT) scan suggested ileocolic intussusception, which was subsequently confirmed by a colonoscopy in our hospital. Adult intussusception is relatively rare, with 90% of cases having a known causative mechanism and 40% of cases caused by primary or secondary malignancies. Therefore, we performed a laparoscopic-assisted right hemicolectomy for the patient. The resected specimen showed that the terminal ileum was intussuscepted into the ascending colon, and the intussusception was hyperemia and edema. A 2.5 cm × 2.5 cm × 1.5 cm mass was seen at the end of the intussusception. Postoperative pathology revealed that the mass was EMZL, partially transformed into a large B-cell lymphoma. The patient was transferred to the hematology department and completed a PET-CT showing postoperative manifestations of primary intestinal lymphoma, Lugano staging IE2. Although EMZL was an indolent lymphoma and the patient was in the early stages, the rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) regimen was given in view of the histological transformation. The patient is in regular follow-up. This was a rare case of small intestinal mass due to EMZL presented as intussusception in adults, which highlighted laparoscopic-assisted enterectomy as a potential therapeutic approach in the multidisciplinary collaborative therapy of small intestine EMZL.
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  • 文章类型: Case Reports
    IgG4相关或IgG4相关垂体炎是一种罕见的疾病,其特征是IgG4阳性浆细胞浸润到垂体组织中。鞍区的神经节细胞瘤也极为罕见,在大多数情况下与垂体腺瘤有关。鞍区粘膜相关淋巴组织(MALT)淋巴瘤是一种极为罕见的疾病。在这项研究中,我们介绍了一例IgG4相关性垂体炎合并MALT淋巴瘤和神经节细胞瘤的病例.然而,阐明潜在的病理生理关系,必须收集更多的IgG4相关性垂体炎伴有MALT淋巴瘤和神经节细胞瘤的病例.
    IgG4-related or IgG4-associated hypophysitis is a rare disease characterized by the infiltration of IgG4-positive plasma cells into pituitary gland tissue. Gangliocytomas in the sellar region are also extremely rare and are associated with pituitary adenomas in the majority of cases. Sellar mucosa-associated lymphoid tissue (MALT) lymphoma is an exceedingly rare condition. In this study, we present a case of IgG4-associated hypophysitis coexisting with MALT lymphoma and gangliocytoma. However, to elucidate the potential pathophysiological relationship, it is imperative to gather additional cases of IgG4-related hypophysitis accompanied by MALT lymphoma and gangliocytoma.
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  • 文章类型: Case Reports
    鞍区原发性结外粘膜相关淋巴组织(MALT)淋巴瘤是一种罕见的惰性B细胞淋巴瘤。
    报道了一名新诊断的源自垂体柄的MALT淋巴瘤患者。在一名24岁的男子中发现了鞍区占位性病变,该男子除了在职前体检中发现的与性激素紊乱(雌激素上升和雄激素下降)有关的症状外,没有临床症状。病理诊断为MALT淋巴瘤。术后建议进行放疗和化疗。然而,患者仅选择雄激素替代疗法而非放化疗.在接下来的3个月里,没有视觉干扰,头痛,颅神经异常,或出现其他症状。
    原发性鞍区MALT淋巴瘤是一种极为罕见的疾病。鞍区和鞍区肿块的鉴别诊断应包括原发性鞍区MALT淋巴瘤。早期发现和治疗淋巴瘤可有效改善预后。
    UNASSIGNED: Primary extranodal mucosa-associated lymphoid tissue (MALT) lymphoma in the sellar region is a rare indolent B-cell lymphoma.
    UNASSIGNED: A newly diagnosed patient with MALT lymphoma originating from the pituitary stalk is reported. A space-occupying lesion in the sellar region was found in a 24 year-old man who had no clinical symptoms except for those relating to a sex hormone disorder (rising estrogen and falling androgen) identified during a pre-employment physical examination. MALT lymphoma was diagnosed pathologically. Radiotherapy and chemotherapy were proposed after surgery. However, the patient selected androgen replacement therapy only rather than chemoradiotherapy. Over the next 3 months, no visual disturbance, headache, cranial nerve abnormality, or other symptoms occurred.
    UNASSIGNED: Primary sellar region MALT lymphoma is an extremely rare disease. The differential diagnosis of sellar and parasellar masses should include primary sellar region MALT lymphoma. Early detection and treatment of this lymphoma can effectively improve the prognosis.
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  • 文章类型: Journal Article
    本研究试图了解临床因素和炎症生物标志物如何影响粘膜相关淋巴组织(MALT)淋巴瘤的预后,并开发预测性列线图以协助临床实践。
    我们对2011年1月至2021年10月的183例新诊断的MALT淋巴瘤患者进行了回顾性研究,随机分为两组:训练队列(75%)和验证队列(25%)。将最小绝对收缩和选择操作员(LASSO)回归分析与多变量Cox回归分析相结合,以构建用于预测MALT淋巴瘤患者无进展生存期(PFS)的列线图。要评估列线图模型的准确性,接收器工作特性(ROC)曲线下的面积,校正曲线,采用决策曲线分析(DCA)。
    PFS与安娜堡阶段显著相关,靶向治疗,放射治疗,MALT淋巴瘤的血小板淋巴细胞比率(PLR)。将这四个变量组合以建立列线图来预测三年和五年的PFS率。重要的是,对于3年和5年PFS,我们的列线图具有良好的预测价值,在训练队列中ROC曲线下面积(AUC)值为0.841和0.763,在验证队列中为0.860和0.879。分别。此外,3年和5年PFS校准曲线显示,预测与实际复发概率高度一致.此外,DCA证明了该列线图的净临床益处及其准确识别高风险患者的能力。
    新的列线图模型可以准确预测MALT淋巴瘤患者的预后,并帮助临床医生设计个体化治疗方案。
    UNASSIGNED: The present study sought to understand how clinical factors and inflammatory biomarkers affected the prognosis of mucosa-associated lymphoid tissue (MALT) lymphoma and develop a predictive nomogram to assist in clinical practice.
    UNASSIGNED: We conducted a retrospective study on 183 cases of newly diagnosed MALT lymphoma from January 2011 to October 2021, randomly divided into two groups: a training cohort (75%); and a validation cohort (25%). The least absolute shrinkage and selection operator (LASSO) regression analysis was combined with multivariate Cox regression analysis to construct a nomogram for predicting the progression-free survival (PFS) in patients with MALT lymphoma. To evaluate the accuracy of the nomogram model, the area under the receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA) were used.
    UNASSIGNED: The PFS was significantly associated with the Ann Arbor Stage, targeted therapy, radiotherapy, and platelet-to-lymphocyte ratio (PLR) in MALT lymphoma. These four variables were combined to establish a nomogram to predict the PFS rates at three and five years. Importantly, our nomogram yielded good predictive value with area under the ROC curve (AUC) values of 0.841 and 0.763 in the training cohort and 0.860 and 0.879 in the validation cohort for the 3-year and 5-year PFS, respectively. Furthermore, the 3-year and 5-year PFS calibration curves revealed a high degree of consistency between the prediction and the actual probability of relapse. Additionally, DCA demonstrated the net clinical benefit of this nomogram and its ability to identify high-risk patients accurately.
    UNASSIGNED: The new nomogram model could accurately predict the prognosis of MALT lymphoma patients and assist clinicians in designing individualized treatments.
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  • 文章类型: Journal Article
    目的:放射治疗在粘膜相关淋巴组织(MALT)淋巴瘤中的作用尚不明确。这项研究的目的是探讨与放疗性能相关的因素,并评估其对MALT淋巴瘤患者预后的影响。
    方法:在美国监测中确定了1992年至2017年间诊断为MALT淋巴瘤的患者,流行病学,和结束结果数据库(SEER)。通过卡方检验评估与放射治疗相关的因素。比较有和没有放疗的患者的总生存期(OS)和淋巴瘤特异性生存期(LSS)。使用Cox比例风险回归模型,早期患者以及晚期患者。
    结果:在确诊为MALT淋巴瘤的10,344例患者中,33.6%曾接受过放疗;I/II期患者为38.9%,III/IV期患者为12.0%,分别。年龄较大的患者和已经接受过初级手术或化疗的患者接受放疗的比例明显较低,不管淋巴瘤的分期。经过单变量和多变量分析,I/II期(HR=0.71[0.65-0.78])和(HR=0.66[0.59-0.74])患者放疗可改善OS和LSS,分别,但在III/IV期患者(HR=1.01[0.80-1.26])和(HR=0.93[0.67-1.29])中没有。根据与I/II期患者总生存期相关的重要预后因素建立的列线图具有良好的一致性(C指数=0.749±0.002)。
    结论:这项队列研究表明,放疗与早期但非晚期MALT淋巴瘤患者的预后良好显著相关。需要进行前瞻性研究以确认放疗对MALT淋巴瘤患者的预后影响。
    OBJECTIVE: The role of radiation therapy in mucosa-associated lymphoid tissue (MALT) lymphoma is poorly defined. The objective of this study was to explore the factors associated with the performance of radiotherapy and to assess its prognostic impact in patients with MALT lymphoma.
    METHODS: Patients with MALT lymphoma diagnosed between 1992 and 2017 were identified in the US Surveillance, Epidemiology, and End Results database (SEER). Factors associated with the delivery of radiotherapy were assessed by chi-square test. Overall survival (OS) and lymphoma-specific survival (LSS) were compared between patients with and without radiotherapy, using Cox proportional hazard regression models, in patients with early stage as well as those with advanced stage.
    RESULTS: Of the 10,344 patients identified with a diagnosis of MALT lymphoma, 33.6% had received radiotherapy; this rate was 38.9% for stage I/II patients and 12.0% for stage III/IV patients, respectively. Older patients and those who already received primary surgery or chemotherapy had a significantly lower rate of receiving radiotherapy, regardless of lymphoma stage. After univariate and multivariate analysis, radiotherapy was associated with improved OS and LSS in patients with stage I/II (HR=0.71 [0.65-0.78]) and (HR=0.66 [0.59-0.74]), respectively, but not in patients with stage III/IV (HR=1.01 [0.80-1.26]) and (HR=0.93 [0.67-1.29]). The nomogram built from the significant prognostic factors associated with overall survival of stage I/II patients had a good concordance (C-index=0.749±0.002).
    CONCLUSIONS: This cohort study shows that radiotherapy is significantly associated with a better prognosis in patients with early but not advanced MALT lymphoma. Prospective studies are needed to confirm the prognostic impact of radiotherapy in patients with MALT lymphoma.
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  • 文章类型: Review
    背景:粘膜相关淋巴组织(MALT)淋巴瘤是一种常见的,低档,恶性B细胞淋巴瘤.然而,同时在胸腺和肺MALT淋巴瘤是极其罕见的,而伴随的肺腺癌则更为罕见。在这里,我们报告了一例罕见的碰撞肿瘤病例,其中在胸腺和肺中均发现了MALT淋巴瘤,并伴有干燥综合征(SS)和肺腺癌。
    方法:对一名32岁女性进行的体格检查发现前上纵隔占位,和胸部计算机断层扫描(CT)显示右肺有结节状的磨玻璃影和不规则的混合密度灶。所有肺癌相关肿瘤生物标志物均在正常范围内。手术切除胸腺和部分肺组织。组织病理学和分子检查证实胸腺和肺的MALT淋巴瘤伴有肺腺癌。SS也被诊断出来。MALT淋巴瘤术后未进行特殊治疗,随访观察4个月后,患者接受了SS的免疫抑制治疗。
    结论:胸腺和肺组织的MALT淋巴瘤在影像学上没有特异性表现,难以与常见恶性肿瘤区分,这些肿瘤的明确诊断高度依赖于组织病理学检查以及分子检测和细胞遗传学。SS可能是胸腺和肺部MALT淋巴瘤发生的重要潜在条件。需要其他类似病例来阐明罕见淋巴瘤和碰撞肿瘤的生物学途径和潜在分子机制。
    BACKGROUND: Mucosa-associated lymphoid tissue (MALT) lymphoma is a common, low-grade, malignant B-cell lymphoma. However, simultaneous MALT lymphoma in the thymus and lung is extremely rare, and concomitant adenocarcinoma of the lung is even rarer. Herein, we report a rare case of a collision tumor in which MALT lymphoma was found in both the thymus and lung with Sjögren\'s syndrome (SS) and adenocarcinoma in the lung.
    METHODS: A physical examination of a 32-year-old woman revealed an anterior superior mediastinal space-occupying lesion, and chest computed tomography (CT) indicated a nodular ground-glass opacity and irregular mixed-density focus in the right lung. All lung cancer-related tumor biomarkers were within normal ranges. The thymus and part of the lung tissue were surgically resected. The histopathology and molecular examinations confirmed MALT lymphoma of the thymus and lung with lung adenocarcinoma. SS was also diagnosed. No special postoperative treatment was performed for the MALT lymphoma, and the patient underwent immunosuppressive therapy for SS after 4 months of follow-up observation.
    CONCLUSIONS: MALT lymphoma of the thymus and lung tissues has no specific presentation on imaging and is difficult to differentiate from common malignant tumors, and the definite diagnoses of these tumors are highly dependent on histopathological examination in combination with molecular testing and cytogenetics. SS may be an important potential condition for the occurrence of MALT lymphoma in the thymus and lung. Additional similar cases are needed to clarify the biological pathways and potential molecular mechanisms of rare lymphomas and collision tumors.
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  • 文章类型: Case Reports
    原发性膀胱粘膜相关淋巴组织(MALT)淋巴瘤是一种极为罕见的膀胱肿瘤。仅报告了很少的报告。我们在此报告一例81岁女性膀胱肿瘤患者,表现为尿频和排尿困难,其骨盆磁共振成像(MRI)认为膀胱癌。她接受了经尿道膀胱肿瘤切除术(TURBT),组织病理学证实肿块为膀胱MALT淋巴瘤。患者拒绝进一步治疗,手术后一年无疾病复发。目前的数据不足以得出关于这种肿瘤治疗的长期疗效的结论,定期跟进是必要的。为了进一步了解临床特征,病理学,这种肿瘤的治疗和预后,我们搜索了从1990年到现在的文献,分析64例原发性MALT淋巴瘤。
    Primary bladder mucosa-associated lymphoid tissue (MALT) lymphoma is an extremely rare bladder tumor. Only scarce reports have been reported. We hereby report a case of an 81-year-old female patient with bladder tumor presenting with frequent urination and dysuria, whose pelvic magnetic resonance imaging (MRI) considered bladder cancer. She underwent transurethral resection of the bladder tumor (TURBT), and histopathology confirmed the mass to be bladder MALT lymphoma. The patient refused further treatment, and no disease recurrence one year after surgery. The current data are insufficient to draw conclusions about the long-term efficacy of treatment for this tumor, regular follow-up is necessary. To further understand the clinical features, pathology, treatment and prognosis of this tumor, we have searched the literature from 1990 to the present, analyzing a total of 64 cases of primary MALT lymphoma.
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  • 文章类型: Journal Article
    粘膜相关淋巴组织(MALT)淋巴瘤是一种B细胞肿瘤,在患有慢性幽门螺杆菌感染的个体的胃中发展了数十年。我们开发了一种新的人类胃MALT淋巴瘤小鼠模型,其中具有先天免疫分子的骨髓特异性缺失的小鼠,Nlrc5在螺杆菌感染后仅3个月发展为MALT淋巴瘤的前体B细胞病变,而在现有模型中9-24个月。Nlrc5敲除小鼠的胃B细胞病变具有人类疾病的组织病理学特征,特别是淋巴上皮样病变,中心细胞样细胞,并被树突状细胞(DC)浸润,巨噬细胞,和T细胞(CD4+,CD8+和Foxp3+)。小鼠和人胃组织含有表达免疫检查点受体程序性死亡1(PD-1)及其配体PD-L1的免疫细胞,表明免疫抑制组织微环境。我们接下来确定CD40L,在一系列B细胞恶性肿瘤中过表达,可能是治疗胃MALT淋巴瘤的潜在药物靶点。重要的是,我们表明,抗CD40L抗体的给药与螺杆菌感染同时或在螺杆菌感染建立后可预防小鼠胃B细胞病变,与对照抗体治疗相比。施用CD40L抗体的小鼠的胃DC数量也显著减少,CD8+和Foxp3+T细胞,以及B细胞淋巴瘤基因的胃表达降低。这些发现证实了CD40L作为治疗人胃B细胞MALT淋巴瘤的治疗靶标的潜力。©2023作者。由JohnWiley&SonsLtd代表英国和爱尔兰病理学会出版的病理学杂志。
    Mucosa-associated lymphoid tissue (MALT) lymphoma is a B-cell tumour that develops over many decades in the stomachs of individuals with chronic Helicobacter pylori infection. We developed a new mouse model of human gastric MALT lymphoma in which mice with a myeloid-specific deletion of the innate immune molecule, Nlrc5, develop precursor B-cell lesions to MALT lymphoma at only 3 months post-Helicobacter infection versus 9-24 months in existing models. The gastric B-cell lesions in the Nlrc5 knockout mice had the histopathological features of the human disease, notably lymphoepithelial-like lesions, centrocyte-like cells, and were infiltrated by dendritic cells (DCs), macrophages, and T-cells (CD4+ , CD8+ and Foxp3+ ). Mouse and human gastric tissues contained immune cells expressing immune checkpoint receptor programmed death 1 (PD-1) and its ligand PD-L1, indicating an immunosuppressive tissue microenvironment. We next determined whether CD40L, overexpressed in a range of B-cell malignancies, may be a potential drug target for the treatment of gastric MALT lymphoma. Importantly, we showed that the administration of anti-CD40L antibody either coincident with or after establishment of Helicobacter infection prevented gastric B-cell lesions in mice, when compared with the control antibody treatment. Mice administered the CD40L antibody also had significantly reduced numbers of gastric DCs, CD8+ and Foxp3+ T-cells, as well as decreased gastric expression of B-cell lymphoma genes. These findings validate the potential of CD40L as a therapeutic target in the treatment of human gastric B-cell MALT lymphoma. © 2023 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.
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  • 目的:回顾性分析头颈部MALT淋巴瘤的一般特点,为临床医生提供新的诊治思路。
    方法:获得121例完整随访数据114例(94.2%)。对2010年至2020年诊断为MALT的114例患者进行了单中心回顾性研究。
    结果:114例患者中有42例(36.8%)以前患有干燥综合征,SS-MALT与非SS-MALT在性别上存在显著差异。至于治疗方法,有或没有放化疗的手术之间的总生存期没有显著差异.
    结论:头颈部MALT淋巴瘤的临床特征是预后良好,总是与SS相关联。有或没有放化疗的手术在延长生存时间方面差异不大。
    To retrospectively analyze the general characteristics of MALT lymphoma in the head and neck and provide clinicians with new ideas for diagnosis and treatment.
    114 (94.2%) of 121 complete follow-up data were obtained. A single-center retrospective study was conducted on 114 patients with MALT diagnosed from 2010 to 2020.
    42 (36.8%) of 114 patients had Sjogren\'s syndrome before, and there is a significant difference in gender between SS-MALT and non-SS-MALT. As for the treatment method, there is no significant difference in the overall survival between surgery with or without chemoradiotherapy.
    MALT lymphoma of the head and neck is clinically characterized by a favorable prognosis, always associated with SS. Surgery with or without chemoradiotherapy has little difference in the prolongation of survival time.
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  • 文章类型: Journal Article
    背景:眼外肌通常受甲状腺疾病或炎性假瘤的影响,但很少有肿瘤形成过程。原发性恶性淋巴瘤累及孤立眼外肌非常罕见,尤其是慢性肌炎6年后。
    方法:一名中年女性,表现为右眼下眼睑肿胀2个月。磁共振成像显示右直肌下腹明显增大。患者在6年前首次出现上眼睑肿胀。在6年内共进行了5次右眼手术活检,连续发现:炎性假瘤,慢性炎症,炎性病变,IgG4相关眼科疾病,最后,粘膜相关淋巴组织眼外肌结外边缘区B细胞淋巴瘤(MALT淋巴瘤)。
    结论:MALT淋巴瘤可能是慢性眼外肌炎的结果。复发性无痛性眼外肌肥大患者应考虑恶性肿瘤。鉴别诊断可以排除甲状腺相关眼病(TAO),他们的症状相似。如有必要,应通过活检进行诊断确认。
    BACKGROUND: Extraocular muscle is usually affected by thyroid disease or inflammatory pseudotumor, but seldom by neoplastic process. Primary malignant lymphoma involving isolated extraocular muscle is very rare, especially after 6 years of chronic myositis.
    METHODS: A middle-aged female presented with swelling of the lower lid of the right eye for 2 months. Magnetic resonance imaging showed significant enlargement of the right inferior rectus muscle belly. The patient first presented 6 years prior with upper eyelid swelling. A total of 5 surgical biopsies of the right eye were performed during 6 years with the following successive findings: inflammatory pseudotumor, chronic inflammation, inflammatory lesions, IgG4-related ophthalmic disease, and lastly, extraocular muscle extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma).
    CONCLUSIONS: MALT lymphoma may have occurred as a result of chronic extraocular myositis. Malignancy should be considered in patients with recurrent painless extraocular muscle hypertrophy. Differential diagnosis can rule out thyroid-associated ophthalmopathy (TAO), whose symptoms are similar. Diagnosis confirmation by biopsy is warranted if necessary.
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