LACRIMAL GLAND LYMPHOMA - A CYTOMORPHOLOGIC AND IMMUNOPHENOTYPIC STUDY

The cytomorphology of lacrimal gland lymphoma has not been specificall y described. Herein we present six cases of histologically proven lacr imal gland lymphoma which we analyzed using fine-needle aspiration cyt ology, cell suspension immunophenotype analysis, and immunoglobulin ge ne rearrangement studies. Fine-needle aspiration cytology revealed aty pical populations of cells comprised of either monomorphic small round lymphocytes with or without plasmacytoid features (4 cases), a mixed population of small and large irregular lymphocytes (1 case), or a pop ulation of large irregular lymphocytes (1 case). The initial cytologic diagnosis was malignant lymphoma in all six cases. Cell suspension im munophenotype analysis demonstrated that the lesions were composed pre dominantly of B-cells that expressed monotypic surface immunoglobulin. Three cases demonstrated an immunoglobulin heavy chain gene rearrange ment. The atypical cytologic features and the abnormal immunophenotype were consistently predictive of malignant lymphoma. Given that these lesions are small and biopsy material is often limited, fine-needle as piration offers the advantage of providing tissue that is ideal for cy tologic and cell suspension immunophenotype evaluation, obviating the need to provide surgical biopsy material for this purpose. We conclude that fine-needle aspiration can identify malignant lymphoid lesions o f the lacrimal gland and may serve as a valuable adjunct in the assess ment of these lesions. Additional study is warranted to determine whet her fine-needle aspiration can reliably distinguish between benign and malignant lymphoid proliferations of the lacrimal gland. (C) Wiley-Li ss, Inc.