The Elusive Nature of Primary Intraocular Lymphoma

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Title Journal of Neuro-Ophthalmology, March 2005, Volume 25, Issue 1
Date 2005-03
Language eng
Format application/pdf
Type Text
Publication Type Journal Article
Collection Neuro-Ophthalmology Virtual Education Library: Journal of Neuro-Ophthalmology Archives: https://novel.utah.edu/jno/
Publisher Lippincott, Williams & Wilkins
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Rights Management © North American Neuro-Ophthalmology Society
ARK ark:/87278/s6dr61jp
Setname ehsl_novel_jno
ID 225426
Reference URL https://collections.lib.utah.edu/ark:/87278/s6dr61jp

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Title The Elusive Nature of Primary Intraocular Lymphoma
Creator Fahim, DK; Bucher, R; Johnson, MW
Affiliation Kellogg Eye Center and Department of Ophthalmology and Visual Sciences, University of Michigan Medical School, Ann Arbor, MI 48105, USA.
Abstract A 58-year-old woman with an initial diagnosis of multiple evanescent white dot syndrome OU experienced deteriorating vision despite corticosteroid treatment. Reevaluation disclosed retinal and subretinal infiltrates and pigmentary alterations, prompting a suspicion of primary intraocular lymphoma (PIOL). Diagnostic vitrectomy yielded inconclusive cytology, but flow cytometry demonstrated small monoclonal B cells less suggestive of PIOL than of small lymphocytic lymphoma originating outside the eye or central nervous system. Brain magnetic resonance imaging, chest/abdomen/pelvis computed tomography, lumbar puncture, and laboratory studies failed to disclose lymphoma elsewhere. There was insufficient evidence to recommend radiation therapy. Vision deteriorated rapidly, prompting a diagnostic retinal biopsy and aspiration of the subretinal infiltrate, revealing unequivocal evidence of PIOL. After 40 Gy orbital x-irradiation, visual function improved dramatically. This case emphasizes the unusual ocular manifestations of PIOL and the difficulty of obtaining a definitive diagnosis by sampling vitreous, particularly after corticosteroid treatment. In such cases, subretinal aspiration or retinal biopsy may be necessary. Timely diagnosis is critical because treatment can reverse visual loss if it is not severe.
Subject Biopsy; Diagnosis, Differential; Eye Neoplasms, diagnosis; Eye Neoplasms, physiopathology; Eye Neoplasms, radiotherapy; Female; Flow Cytometry; Fluorescein Angiography; Fundus Oculi; Humans; Lymphoma, diagnosis; Lymphoma, physiopathology; Lymphoma, radiotherapy; Middle Older people; Retina, pathology; Retinal Diseases, diagnosis; Treatment Outcome; Vision, Ocular
OCR Text Show
Format application/pdf
Publication Type Journal Article
Collection Neuro-Ophthalmology Virtual Education Library: Journal of Neuro-Ophthalmology Archives: https://novel.utah.edu/jno/
Publisher Lippincott, Williams & Wilkins
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Rights Management © North American Neuro-Ophthalmology Society
Setname ehsl_novel_jno
ID 225417
Reference URL https://collections.lib.utah.edu/ark:/87278/s6dr61jp/225417
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