Ocular adnexal lymphoid tumors. Correlative ultrastructural and immunologic marker studies
F. A. Jakobiec, T. Iwamoto and D. M. Knowles 2nd
Twenty-two ocular adnexal lymphoid infiltrates were analyzed by electron
microscopy as well as immunologically and cytochemically. Five reactive
polyclonal lesions were found to be preponderantly composed of small mature
lymphocytes (presumably T cells) with clumped nuclear chromatin, sparse
cytoplasmic organelles, and numerous monoribosomes. In 11 monoclonal B-cell
lesions, both the 1-micrometer plastic sections examined by light
microscopy and the electron micrographs disclosed immature cells, with more
dispersed nuclear chromatin, prominent nucleoli, abundant cytoplasmic
polyribosomes, and increased numbers of mitochondria and strands of
endoplasmic reticulum particularly in plasmacytoid lesions). The remaining
six monoclonal B-cell lesions were composed of comparatively
well-differentiated cells requiring electron microscopy to show somewhat
more prominent nucleoli, slightly less dense clumping of the nuclear
chromatin, increased numbers of mitochondria and short segments of
rough-surfaced endoplasmic reticulum, and monoribosomes rather than
polyribosomes. The importance of distinguishing this group of
well-differentiated monoclonal lesions from the less well-differentiated
ones was underscored by the results of the follow-up examinations, in that
no evidence of extraorbital disease has been discovered in the former
group, while a 50% incidence occurred in the latter.
