THE ROLE OF PROLIFERATING CELL NUCLEAR ANTIGEN (PCNA) IN PREDICTING BIOLOGIC BEHAVIOR OF LYMPHOID INFILTRATES OF THE ORBIT AND OCULAR ADNEXAE

The authors performed a retrospective clinicopathologic review of lymp hoid tumors of the orbit and ocular adnexa. In addition, we used an im munohistologic marker for proliferating cell nuclear antigen (PCNA), a n intranuclear protein with greatest expression in actively proliferat ing (dividing) cells, to determine whether levels of PCNA can be corre lated with the presence or future development of systemic lymphoma. To the authors' knowledge, the present study represents the first in whi ch PCNA indices, i.e., the number of cells that showed diffuse intranu clear staining for PCNA averaged per 10 high power field (HPF), were c orrelated with systemic disease in orbital and ocular adnexal lymphoma s. The percentage of B-and T-cells in the tumor infiltrate was also de termined. Followup data showed that two patients with eyelid involveme nt had preexisting systemic lymphoma, whereas another with bilateral l acrimal gland disease later developed systemic lymphoma. Followup time s ranged from 24 to 32 months (mean 39.7 months). The mean PCNA level in three patients with systemic disease was 13.3 and in the six patien ts with no systemic disease was 33.8. These results suggest that PCNA alone cannot be used as a marker for the presence of, or development i nto, systemic lymphoma.