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Presumptive primary intraocular lymphoma presented as an intraocular mass involving the optic nerve head.

Hedayatfar A, Phaik Chee S - J Ophthalmic Inflamm Infect (2011)

View Article: PubMed Central - PubMed

Affiliation: Ocular Inflammation and Immunology Department, Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore, 168751, Singapore, Alireza28@yahoo.com.

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Primary intraocular lymphoma (PIOL) is a subset of primary central nervous system (CNS) lymphoma which initially presents in the eye with or without simultaneous CNS involvement... Diagnosis of PIOL requires histopathologic evidence of malignant lymphoma cells in brain biopsy, vitreous or CSF specimen... Optic nerve and optic disc involvement may occur in the PIOL... A 52-year-old healthy female presented with a 2-month history of sudden and progressive painless visual impairment in her left eye... Careful review of history did not reveal additional clues except that she had been having mild frontal headache for 2 years... Smear and culture of vitreous specimen did not show the evidence of bacteria or fungi... Vitreous tap was done but cytology did not reveal the presence of malignant cells... The histopathologic and immunohistochemistry features were consistent with the diagnosis of a large B cell lymphoma (Fig.  3)... Systemic examination and further extensive investigations did not show involvement of other sites... She was diagnosed with the primary intraocular-CNS lymphoma and was treated with the De Angelis chemotherapy protocol without adjunctive radiotherapy... One month later, the brain MRI revealed a remarkable decrease in the size of intracranial tumor, and fundus examination showed significant decrease in the vitreous haze with disappearance of the mass, but the visual acuity did not improve, and she remained with a pale optic disc and some peripapillary atrophic lesions (Fig.  4)... This was revealed by close vicinity between the intraocular mass and optic disc in B-scan and magnetic resonance images... The profound loss of vision and significant relative afferent pupillary defect early in the course of the disease further support this assumption... Although optic nerve and optic disc infiltration have been reported in primary intraocular lymphoma, this case represents an unusual presentation of presumptive intraocular lymphoma featuring as an intraocular mass with involvement of optic nerve head that to our knowledge has not been reported yet.

No MeSH data available.


Related in: MedlinePlus

Fundus photograph of the same patient after chemotherapy: pale optic disc together with prepapillary atrophic lesions. Note the disappearance of the mass and vitreous haziness
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Fig4: Fundus photograph of the same patient after chemotherapy: pale optic disc together with prepapillary atrophic lesions. Note the disappearance of the mass and vitreous haziness

Mentions: Systemic examination and further extensive investigations did not show involvement of other sites. She was diagnosed with the primary intraocular-CNS lymphoma and was treated with the De Angelis chemotherapy protocol without adjunctive radiotherapy. One month later, the brain MRI revealed a remarkable decrease in the size of intracranial tumor, and fundus examination showed significant decrease in the vitreous haze with disappearance of the mass, but the visual acuity did not improve, and she remained with a pale optic disc and some peripapillary atrophic lesions (Fig. 4).Fig. 4


Presumptive primary intraocular lymphoma presented as an intraocular mass involving the optic nerve head.

Hedayatfar A, Phaik Chee S - J Ophthalmic Inflamm Infect (2011)

Fundus photograph of the same patient after chemotherapy: pale optic disc together with prepapillary atrophic lesions. Note the disappearance of the mass and vitreous haziness
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3302991&req=5

Fig4: Fundus photograph of the same patient after chemotherapy: pale optic disc together with prepapillary atrophic lesions. Note the disappearance of the mass and vitreous haziness
Mentions: Systemic examination and further extensive investigations did not show involvement of other sites. She was diagnosed with the primary intraocular-CNS lymphoma and was treated with the De Angelis chemotherapy protocol without adjunctive radiotherapy. One month later, the brain MRI revealed a remarkable decrease in the size of intracranial tumor, and fundus examination showed significant decrease in the vitreous haze with disappearance of the mass, but the visual acuity did not improve, and she remained with a pale optic disc and some peripapillary atrophic lesions (Fig. 4).Fig. 4

View Article: PubMed Central - PubMed

Affiliation: Ocular Inflammation and Immunology Department, Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore, 168751, Singapore, Alireza28@yahoo.com.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Primary intraocular lymphoma (PIOL) is a subset of primary central nervous system (CNS) lymphoma which initially presents in the eye with or without simultaneous CNS involvement... Diagnosis of PIOL requires histopathologic evidence of malignant lymphoma cells in brain biopsy, vitreous or CSF specimen... Optic nerve and optic disc involvement may occur in the PIOL... A 52-year-old healthy female presented with a 2-month history of sudden and progressive painless visual impairment in her left eye... Careful review of history did not reveal additional clues except that she had been having mild frontal headache for 2 years... Smear and culture of vitreous specimen did not show the evidence of bacteria or fungi... Vitreous tap was done but cytology did not reveal the presence of malignant cells... The histopathologic and immunohistochemistry features were consistent with the diagnosis of a large B cell lymphoma (Fig.  3)... Systemic examination and further extensive investigations did not show involvement of other sites... She was diagnosed with the primary intraocular-CNS lymphoma and was treated with the De Angelis chemotherapy protocol without adjunctive radiotherapy... One month later, the brain MRI revealed a remarkable decrease in the size of intracranial tumor, and fundus examination showed significant decrease in the vitreous haze with disappearance of the mass, but the visual acuity did not improve, and she remained with a pale optic disc and some peripapillary atrophic lesions (Fig.  4)... This was revealed by close vicinity between the intraocular mass and optic disc in B-scan and magnetic resonance images... The profound loss of vision and significant relative afferent pupillary defect early in the course of the disease further support this assumption... Although optic nerve and optic disc infiltration have been reported in primary intraocular lymphoma, this case represents an unusual presentation of presumptive intraocular lymphoma featuring as an intraocular mass with involvement of optic nerve head that to our knowledge has not been reported yet.

No MeSH data available.


Related in: MedlinePlus