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patients. The isolated involvement of extraocular muscles was
revealed in 4 patients. In 4 other cases the tumor was identified
behind the sclerouveal ring surrounding the optic nerve. In 2 cases
the tumor occupied all retrobulbar space. In B-mode examination
the lymphoma presented as a complex formation, including small
hyperechogenic inclusions and thin septations in the tumor. The
acoustic density of the tumor estimated with densitometry was -44
on average.
Mixed arterio-venous flow imaging of tumor vessels demonstrated
the average systolic flow velocity equaling 15,67cm/c; the indicators
of resistance averaged RI=0,62±0,1 and PI=1,06±0,3. “Large” feeding
arteries with the lower resistance indexes and diastolic flow were
revealed in 50 % of cases.
Conclusions. In concert with existing Methods, the echographic
criteria presented enhance the diagnostic capabilities of malignant
lymphoma of the orbit and allow for more precise determination of
the extent of surgical intervention.
Financial disclosure. None
1752 ECp109
CONJUNCTIVA MALIGNANT MELANOCYTIC TUMORS.
RECURRENCE AND SURVIVAL RATE IN 15 PATIENTS
FROM CHILE
Maria E Manquez1, Pablo Vigorena2, Bruno Nervi3, Pablo Zoroquiain3,
Jeannie Slater4, Arturo Espinoza5 (m_manquez@yahoo.com)
1. Clinica Oftalmlogica Pasteur. Santiago, Chile
2. Hospital Padre Hurtado, Santiago, Chile
3. Universidad Catolica de Chile
4. Hospital Militar Santiago, Chile
5. Citolab, Santiago, Chile
Purpose. To describe the clinical features of affected patients,
regarding age, sex, systemic condition, prior treatment, and to
describe the clinical features of the tumor, extension, presence of lid
/ orbital invasion, and to report recurrence, metastasis and mortality
rate at short term follow up.
Methods. Review of 70 charts of patients with conjunctiva melanocytic
lesions, 15 of them presented malignant tumors. Time of follow up was
36 months ( 12-72).
Results. Regarding patients: the age of presentation was 56 yo ( 33
-88), 74% were female, 80% wiith dark hair, borwon iris. None were
immunosuppressed.
Regarding tumors: 74% of cases presented melanoma with pam with
atypia, 26% with pam with severe atypia. 70% of cases had at least 1
prior recurrence.
Orbital involvement was observed in 20% of the cases
Recurrence after treatment was observed in 8% of pts with prior
surgery and 0% of those with no prior treatment.
The survival rate was 94%.
Conclusions. Mlaignant melanocytic are observed no only in caucasians
but also in hispanic patients. Our patients seems to be younger at the
time of presentation. Females are more often affected.
Most of our patients are referred late, after at least 1 surgery.
Those patients with no prior surgery, present good outcome with no
recurrence at short term follow up.
Financial disclosure. None
EYELID, CONJUNTIVA & ORBIT
Abstract Posters
85
66 ECp110
LYMPHOPROLIFERATIVE TUMORS OF THE LACRIMAL
GLAND: ANALYSIS OF CLINICAL FEATURES AND
SYSTEMIC INVOLVEMENT
Hakan Demirci, Shivani Gupta, Carol L. Shields, Jerry A. Shields, Victor
M. Elner,
(hdemirci@med.umich.edu)
W. K. Kellogg Eye Center, University of Michigan, Ann Arbor, MI
Oncology Service, Wills Eye Institute, Philadelphia, PA
Purpose. The lacrimal gland is an only ocular adnexal tissue that
contains native lymphocytes. Despite its unique property, isolated
primary involvement of the lacrimal gland is rare in lymphoproliferative
tumors of the ocular adnexa. There is no information about the risk
for systemic lymphoma in the patients with isolated lacrimal gland
lymphoproliferative tumors.
Methods. We retrospectively reviewed clinical features and treatment
method of 40 patients with isolated lacrimal gland tumor. Data from 33
patients without systemic disease at presentation were analyzed for
their impact on the occurrence of systemic lymphoma.
Results. At presentation, tumor was unilateral in 22 (55%) patients and
bilateral in 18 (45%). Of 40 patients, 20 (50%) patients had marginal
zone B-cell lymphoma, 13 (33%) patients had follicular lymphoma, 3
(8%) patients had mantle cell lymphoma and 2 (5%) patients had diffuse
large B-cell lymphoma. Thirty-five (88%) patients were managed with
external beam radiotherapy, 2 (5%) patients were treated with systemic
chemotherapy and 2 (5%) patients were managed with excisional
biopsy.
Systemic lymphoma was detected in 11 (28%) patients. Systemic
involvement was diagnosed before the lacrimal gland tumor in 2 (5%)
patients, at the time of diagnosis of the lacrimal gland tumor in 5 (13%)
patients, and subsequent to the diagnosis of the lacrimal gland tumor in 4
(10%) patients. Of 4 patients in whom systemic lymphoma subsequently
developed, 3 (75%) patients had follicular lymphoma and 1(25) patient
had diffuse large B- cell lymphoma. Using Kaplan-Meier estimates of 30
patients without systemic involvement, systemic lymphoma developed
in 16% at 3 and 5 years, and 58% at 10 years.
Conclusions. The majority of lacrimal gland lymphoproliferative tumors
were either marginal zone B-cell or follicular lymphoma. In patients
with lacrimal gland lymphoproliferative tumor alone at presentation,
systemic lymphoma eventually developed in 16% at 5 years and 58%
at 10 years. Development of systemic lymphoma was associated with
follicular or diffuse large B-cell lymphoma of the lacrimal gland.
Financial disclosure. None
224 ECp111
IMMUNOHISTOCHEMICAL AND MOLECULAR STUDY
OF OPTIC PATHWAY GLIOMAS
Charles G. Eberhart, J. Douglas Cameron, Elizabeth J. Rushing, Matthias
Karajannis, Fausto J. Rodriguez, (ceberha@jhmi.edu)
Johns Hopkins University, Baltimore, MD; Armed Forces Institute of
Pathology, Washington, DC; New York University, NYC
Purpose. Optic pathway gliomas (OPG) represent a specific subtype of
astrocytoma with unique clinicopathologic and biological properties.
OPG may occur in the setting of NF1 syndrome or sporadically, and
at the pathologic level are pilocytic astrocytomas. Recent studies