Diagnosis and treatment of orbital malignant lymphoma: A 14-year review atYamagata University

Purpose: With the recent increase in the incidence of orbital malignant lym phoma, it is important to make the appropriate decision on effective treatm ent. The purpose of the current study was to develop a protocol to treat or bital malignant lymphoma based on evidence from histopathological examinati on. Methods: In the present study we analyzed the records of 18 cases of orbita l lymphoma treated in the Yamagata University Hospital over the past 14 yea rs, including 6 cases of isolated orbital disease and 12 cases of systemic disease. The tentative strategy for selecting the treatment was as follows: the cases at clinical stage I (Ann Arbor criteria) were treated with curat ive intent, and the cases at stages II-IV were treated with palliative inte nt. This: strategy was evaluated from the viewpoints of efficacy and side e ffects. Results: Histopathologically, all B cases of isolated orbital disease were classified as low-grade malignancy, 3 of the systemic disease cases were cl assified as low-grade, and 9 were classified as inter mediate-grade maligna ncy. The isolated orbital disease cases at stage I were treated by radiatio n or chemotherapy. The systemic disease cases at stages II-IV were treated by chemotherapy and/or radiation. The lymphoma disappeared completely in al l 6 isolated orbital disease cases. Although the survival rate was 42% in s ystemic disease cases after a mean period of 15-month observation, the ocul ar complications decreased with an improved quality of life. Conclusions: It is important to determine the histological features and cli nical stages in order to choose the appropriate treatment methods. All the isolated orbital disease cases were treated effectively by radiation or che motherapy. Our strategy for the treatment of the systemic disease cases con tributed to the decrease in ocular complications and the improvement in the quality of life for the patients. (C) 2001 Japanese Ophthalmological Socie ty.