Ocular Adnexal Marginal Zone Lymphoma: Retrospective Analysis and Clinical-Pathological Features

OpenAlex İngilizce

Objective: Ocular adnexal lymphomas are rare malignancies, accounting for approximately 1–2% of all non-Hodgkin lymphomas and 8–10% of extranodal lymphomas. Among these, ocular adnexal marginal zone lymphoma (OA-MZL) represents the predominant histologic subtype, comprising 55–80% of all orbital/ocular adnexal lymphomas. The aim of this study is to retrospectively evaluate the clinical and histopathological features of cases diagnosed with ocular adnexal marginal zone lymphoma (OA-MZL) and to compare the findings with the current literature. Methods: A total of 10 OA-MZL cases diagnosed between 2010 and 2025 in the archives of the Department of Pathology, Celal Bayar University, Manisa, with conjunctival and/or lacrimal gland involvement were included in this study. The slides of all cases were retrieved from the archives and re-evaluated under a microscope. Previously prepared hematoxylin–eosin sections and immunohistochemical slides were re-evaluated to confirm the diagnosis. The patients' clinical data, treatment protocols, and follow-up results were obtained from the hospital information system. Clinicopathological parameters were documented, and a descriptive statistical analysis was conducted and the data obtained were compared with the literature. Results: The mean age of the cases was 65.9 (39-82), and the female/male ratio was 3/7. The most common presenting symptom was orbital swelling. Histopathological examination revealed diffuse monomorphic small lymphoid cell infiltration, and the immunohistochemical panel applied showed tumor cells to be CD20 and BCL2 positive, CD3, CD5, CD21, CD23, Bcl-6, CD10, and Cyclin D1 negative. The mean Ki-67 index was 13.3%. Plasmacytic differentiation was observed in 2 cases. Three patients received definitive radiotherapy, whereas six patients were monitored with active surveillance due to indolent disease behavior. The mean follow-up period was 50 months, and recurrence was detected in 1 case. Conclusion: Ocular adnexal marginal zone lymphomas are neoplastic proliferations that are clinically indolent but require careful histopathological differential diagnosis. This study aims to contribute by presenting and evaluating the clinical and pathological findings of these rare localizations in the context of the literature.