Asbestos Cancer Update 2008

The New York Eye Cancer Center, 115 East 61st Street, New York, NY 10065, USA.

AIM: To evaluate 18-fluoro-2-deoxyglucose (FDG) whole-body positron emission tomography/computed radiographic tomography (PET/CT) for lymph node and metastatic staging of patients with conjunctival melanoma. METHODS: Fourteen patients with T3 (n = 13) and T4 (n = 1) conjunctival melanoma (as defined in Chapter 42 of the AJCC staging manual) were staged for metastatic disease with PET/CT imaging with fusion. The patients had lymph node and clinical staging evaluations before PET/CT imaging. PET/CT images were studied for the presence and distribution of metastatic conjunctival melanoma (determined by standardised uptake values) and later confirmed by biopsy. MRI imaging was performed if abnormalities were noted on PET/CT images. RESULTS: Fourteen patients with conjunctival melanoma underwent PET/CT imaging. Seven were newly diagnosed (presurgical screening), and seven had undergone prior treatment (follow-up group). Only one patient with conjunctival melanoma (7.1%) was found to have metastatic disease on PET/CT imaging. Abnormal foci were found in the liver, lung, peritoneal cavity, lumbar spine as well as a supraclavicular node (T4N1M4). All liver function tests were normal. The mean length of follow-up after PET/CT imaging was 13 months (range 4-30 months). CONCLUSIONS: PET/CT imaging did not reveal any regional or systemic metastasis among 14 patients with advanced, diffuse and multifocal disease.

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Department of Ophthalmology, Chungnam National University Hospital, #640 Daesa-dong, Jung-gu, Daejeon 301-721, Korea. kcs61@cnu.ac.kr

BACKGROUND/AIMS: Helicobacter pylori is well known to be responsible for gastric mucosa-associated lymphoid tissue (MALT) lymphoma. This study evaluates whether H pylori is also responsible for conjunctival MALT lymphoma and which strain of H pylori is associated with conjunctival MALT lymphoma. METHODS: Fifteen cases of conjunctival MALT lymphoma were investigated. Eight biopsies of normal conjunctiva were also investigated as controls. The specimens were investigated for the presence of H pylori DNA with polymerase chain reaction (PCR) using 16S rDNA primer. When the PCR using 16S rDNA was positive for H pylori, the specimens were analysed for the virulent gene with PCR using vacA s1/2 primer and vacA m1/2 primer. RESULTS: H pylori DNA was identified in all 15 specimens of conjunctival MALT lymphomas and none of the controls. Of these 15 H pylori positive lymphoma specimens, the vacA s1 and vacA m2 alleles were detected in two, and only vacA s1 allele was detected in 11. CONCLUSIONS: H pylori is thought to play a role in the pathogenesis of conjunctival MALT lymphoma, and H pylori with vacA s1 allele appears to be a virulent strain for conjunctival MALT lymphoma.

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