Diagnosis of Reactive Lymphoid Hyperplasia by Chorioretinal Biopsy

Cheung, Margaret K.; Martín, Daniel; Chan, Chi‐Chao; Callanan, David; Cowan, Claude L.; Nussenblatt, Robert B.

doi:10.1016/s0002-9394(14)75796-4

Cited by 35 publications

(13 citation statements)

References 9 publications

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“…Although lymphoid-like infiltration in human eyes with chronic uveitis have been reported, (19, 50) it is not clear at this point whether this represents true TLT, as inflamed retinal tissue cannot be easily obtained from patients for extensive analysis, such as was performed in this study. Our data point to the possibility that immunologically active TLT can form in the eye, which can have implications on clinical aspects of the disease.…”

Section: Discussionmentioning

confidence: 84%

“…However, it is not always clear whether these structures can be considered true “lymphoid tissue” due to the fact that they were reported under malignant or benign neoplastic conditions and there is no data supporting that they express characteristic lymphoid tissue markers. Lymphoid-like tissue in the uvea has been described as reactive lymphoid hyperplasia or intraocular pseudotumor with benign inflammatory disease (19). Patients with this diagnosis were reported to have long-lasting inflammatory cell infiltrate, including plasma cells, lymphocytes, and macrophages.…”

Section: Introductionmentioning

confidence: 99%

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Tertiary Lymphoid Tissue Forms in Retinas of Mice with Spontaneous Autoimmune Uveitis and Has Consequences on Visual Function

Kielczewski

Horai

Jittayasothorn

et al. 2016

The Journal of Immunology

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During chronic inflammation, tertiary lymphoid tissue (TLT) can form within an inflamed organ, including the central nervous system (CNS). However, little is known about TLT formation in the neuroretina. In a novel spontaneous autoimmune mouse model of uveitis (R161H), we identified well-organized lymphoid aggregates in the retina and examined them for TLT characteristics. Presence of immune cells, tissue-specific markers, and gene expression patterns typically associated with germinal centers and T follicular helper (TFH) cells were examined using immunohistochemistry and gene analysis of laser capture microdissected retina. Our data revealed the retinal lymphoid structures contained CD4+ T cells and B cells in well-defined zonal areas that expressed classic germinal center markers, PNA and GL-7. Gene expression analysis showed upregulation of T follicular helper cell markers, most notably CXCR5 and its ligand CXCL13, and immunohistochemical analysis confirmed CXCR5 expression, typically associated with CD4+ T follicular helper cells. Highly organized stromal cell networks, a hallmark of organized lymphoid tissue, were also present. Positive staining for phospho-Zap70 in retina-specific T cells indicated CD4+ T cells were being activated within these lymphoid structures. CD138+/B220+ plasma cells were detected, suggesting the retinal lymphoid aggregates give rise to functional germinal centers, which produce antibodies. Interestingly, eyes with lymphoid aggregates exhibited lower inflammatory scores by fundus examination and a slower initial rate of loss of visual function by electroretinography, compared to eyes without these structures. Our findings suggest that the lymphoid aggregates in the retina of R161H mice represent organized TLT, which impact the course of chronic uveitis.

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Section: Discussionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Tertiary Lymphoid Tissue Forms in Retinas of Mice with Spontaneous Autoimmune Uveitis and Has Consequences on Visual Function

Kielczewski

Horai

Jittayasothorn

et al. 2016

The Journal of Immunology

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“…But, bilaterality, fluorescein findings, HLA typing and lack of extrascleral nodules led us to the diagnosis of VKH disease and treatment with pulse dose steroids. It is worth noting that uveal lymphoproliferation may also respond in a similar way to the pulse dose steroids administered 13. However, our patient was also started on mycophenylate mofetil and has been tapered off steroids completely without recurrence for 12 months with visual acuity at last follow-up of 20/20 bilateral.…”

Section: Discussionmentioning

confidence: 60%

Vogt–Koyanagi–Harada disease masquerading as a lymphoproliferative process of the uvea

et al. 2013

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“…Some authors performed biopsies of the episcleral tumour nodules to establish the diagnosis of either malignant lymphoma [9] or RLH [2]. Chorioretinal biopsy was used to diagnose RLH of the uvea by Cheung et al [3]. The present case illustrates one of the few cases of primary uveal EMZL diagnosed on the basis of chorioretinal biopsy.…”

Section: Discussionmentioning

confidence: 80%

Diagnosis of a primary uveal extranodal marginal zone B-cell lymphoma by chorioretinal biopsy: case report

Coupland

Joussen

Anastassiou

et al. 2004

Graefe's Arch Clin Exp Ophthalmol

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Diagnosis of Reactive Lymphoid Hyperplasia by Chorioretinal Biopsy

Cited by 35 publications

References 9 publications

Tertiary Lymphoid Tissue Forms in Retinas of Mice with Spontaneous Autoimmune Uveitis and Has Consequences on Visual Function

Tertiary Lymphoid Tissue Forms in Retinas of Mice with Spontaneous Autoimmune Uveitis and Has Consequences on Visual Function

Vogt–Koyanagi–Harada disease masquerading as a lymphoproliferative process of the uvea

Diagnosis of a primary uveal extranodal marginal zone B-cell lymphoma by chorioretinal biopsy: case report

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