RETRO-BULBAR PRIMARY NON-HODGKIN’S LYMPHOMA: A RARE CASE REPORT (original) (raw)
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Case Report: Intraocular Non-Hodgkin Lymphoma
Journal of Clinical Case Reports, 2015
Purpose: Primary intraocular lymphoma is a primary central nervous system lymphoma in which lymphoma cells invade the retina, vitreous, or optic nerve head without concomitant central nervous system involvement. The aim of this presentation is to report a case of primary intraocular non-Hodgkin lymphoma. Methods: The authors present a case report of a 77 years-old female with painless decreased in visual acuity and floaters. Ophthalmic examination, Static computerized Perimetry, Spectral-Domain Optical Coherence Tomography, angiography, laboratory study, lumbar puncture, computed tomography scan and magnetic resonance imaging were performed. Results: On examination, best corrected visual acuity was 20/25 in the right eye and 30/60 in the left eye. Slip lamp examination revealed anterior chamber reaction and fundoscopy showed vitritis, optic disc edema, macular edema and vasculitis in left eye. After three months of follow-up, the patient's best corrected visual acuity decreased to 20/60 in right eye and light perception in left eye. Fundoscopy revealed vitritis, optic disc edema, macular edema and vasculitis in both eyes. A granular pattern, leakage from retinal vessels and optic disc were observed in fluorescein angiography. Infectious and inflammatory etiologies were excluded. Pars plana vitrectomy and retinal biopsy were performed in left eye. Cytology evaluation revealed atypical lymphoid cells with large nuclei, prominent nucleoli and basophilic cytoplasm, and confirmed the diagnosis of intraocular lymphoma. Conclusion: Intraocular Lymphomas are rare malignancies that display a wide array of clinical manifestation, therefore diagnosis can be challenging. It requires a high degree of clinical suspicion and differential diagnosis includes infectious and non-infectious etiologies.
Ocular non-Hodgkin's lymphoma: a clinical study of nine cases
British Journal of Ophthalmology, 1997
Background-Primary oculocerebral large cell malignant non-Hodgkin's lymphoma, formerly called ocular reticulum cell sarcoma, runs a uniformly fatal course. Once the central nervous system (CNS) is involved, survival without treatment is very limited. Although treatment does not substantially improve the long term survival, it provides short term improvement in these patients. Methods-The charts of all patients with ocular involvement of non-Hodgkin's lymphoma followed during the period 1984-93 were reviewed. The diagnosis of non-Hodgkin's lymphoma was made by diVerent diagnostic approaches: CNS biopsy, anterior chamber tap, vitrectomy, haematology, and necropsy. Results-Eight patients had oculocerebral large cell and one had small cell non-Hodgkin's lymphoma. Five patients with pure ocular localisation had initially received steroid treatment for intermediate uveitis. First diagnosis was made on CNS biopsy in three, anterior chamber tap in one, vitreous aspirate in three, haematology in one, and necropsy in one case. Conclusion-Ocular non-Hodgkin's lymphoma is a diYcult diagnosis. Vitrectomy allows cytological diagnosis in most but not all cases. When no treatment is given, patients survive for only a few weeks once the CNS is involved. Although the disease is eventually fatal, treatment by means of radiotherapy, steroid administration, and vitrectomy can allow these patients to lead a normal professional and social life during the years between recurrences.
Clinical course and pathologic features of conjunctival non-Hodgkin's lymphoma
Graefes Archive for Clinical and Experimental Ophthalmology, 1990
Six patients with conjunctival non-Hodgkin's lymphoma (NHL) were evaluated. In all six cases the conjunctiva was the primary site of clinical presentation; four cases involved low-grade malignancy and two, intermediate-grade malignancy, according to the International Working Formulation. The disease developed within a short period of time to stage IV The poor response to therapy revealed a worse prognosis than would be expected according to the histopathologic classification. Four of the six patients died of NHL, three of them within 15 months. Comparison of these 6 cases with a group of 15 patients with orbital NHL revealed a much better prognosis in the latter patients. In spite of the fact that 4 of the 15 orbital cases showed NHL of high-grade malignancy, only 2 of them died of the lymphoma. Therefore, conjunctival NHL requires a fast and adequate diagnostic and therapeutic approach.
Hematological Oncology, 2004
The aims of this study were to define the initial characteristics, natural history, and prognostic factors of patients with ophthalmologic and intraocular malignant lymphoma. All patients treated at the Institut Curie for lymphoma with ophthalmologic (orbit and/or adnexa) or intraocular involvement were retrospectively reviewed. A pathological review of all cases was performed according to the WHO classification. One hundred and fortyfive patients were selected for the study. Pathological review showed 36% MALT type lymphoma, 22% lymphoplasmocytic lymphoma, and 15% diffuse large B-cell lymphoma. Ophthalmologic and ocular sites were intra-orbital in 61 cases (42%) and conjunctival in 51 cases (35%), with bilateral involvement in 10% of cases. Stage IV was found in 32% of cases, with bone marrow involvement in 12%. With a median follow-up of 90 months, the 5-year DFS and OS were 64 and 79% for low-grade NHL, and 43 and 50% for high-grade NHL. On multivariate analysis, age greater than 59 years, elevated LDH level, stage IV, high-grade histological subgroup, and presence of B-symptoms had a negative impact on OS for the overall population. In conclusion, with a median follow-up of 7.5 years, our large cohort of patients represents one of the largest published series on primary ophthalmologic and intraocular malignant lymphoma.
A case of primary B-cell type non-Hodgkin lymphoma originating in the iris
American journal of …, 2003
PURPOSE: To report a case of primary malignant B-cell type non-Hodgkin lymphoma originating in the iris. DESIGN: Interventional case report. METHODS: An 83-year-old woman presented with anterior uveitis resulting from primary malignant lymphoma in the iris. Ultrasound biomicroscopy and indocyanine green angiography using a scanning laser ophthalmoscope showed abnormalities in the iris. Diagnostic biopsy of the iris revealed B-cell type non-Hodgkin lymphoma. RESULT: The patient was treated with radiotherapy, and the tumorous lesion resolved. CONCLUSION: Primary lymphoma localized in the iris only is rare. In this case, diagnostic biopsy and radiotherapy of the iris lymphoma provided good results. (Am J Ophthalmol 2003;136:380 -382.
Hodgkin’s Lymphoma: A Rare Ophthalmic Case Report
Community Based Medical Journal
Hodgkin’s lymphoma (HL) is a disease originating from lymphoid tissues; however, it may pose a diagnostic challenge. Ocular involvement is more prevalent in non-HL compared to HL. We have reported a rare case of Hodgkin’s lymphoma presented with forwarding bulging of left eye with pain, redness, and watering. The patient also complained of painless swelling of the submandibular lymph node when admitted into the National Institute of Ophthalmology and Hospital (NIOH), Dhaka, Bangladesh; later, incision and biopsy was done at ENT & Head-Neck Cancer Hospital, Dhaka, Bangladesh. Histopathology report revealed Hodgkin’s lymphoma. Hodgkin's lymphoma is a malignancy with unknown aetiology. With timely diagnosis and early treatment, our patient began to show gradual improvement with her symptoms. Prompt oncologic treatment and immunotherapy can be beneficial, if instituted early in the course of the disease. CBMJ 2022 July: vol. 11 no. 02 P: 158-161
Ophthalmic Manifestations of Hodgkin Lymphoma: A Review
Ocular Oncology and Pathology, 2021
Background: Hodgkin lymphoma (HL) is a hematopoietic neoplasm characterized by cancerous Reed-Sternberg cells. In contrast to ophthalmic manifestations by non-HL that are well recognized, there is paucity of the literature as it relates to ophthalmic manifestation by HL. We performed a comprehensive review of published studies (case reports and small case series) to characterize the ophthalmic manifestations of HL. Summary: Thirty patients were identified with ophthalmic manifestation of HL. Thirteen (43%) were male, and 14 (46%) were female (in 3 cases, sex was not specified). The median age at ophthalmic presentation was 27 years. Diagnosis of HL was made after ophthalmic manifestation in 10 (33%) cases, whereas 11 (36%) cases had a prior diagnosis of HL. Ophthalmic manifestations can be classified into 3 main groups; direct infiltration, inflammatory reaction, and paraneoplastic process. Seven cases had infiltration of the optic nerve. Uveal inflammatory reaction was reported in ...
Bilateral ocular disease as the initial presentation of malignant lymphoma
British Journal of Ophthalmology, 1988
Malignant lymphocytic lymphoma rarely involves the eye. In two patients we found ocular signs and symptoms as the initial presentation of systemic disease. In the first patient periorbital swelling and ptosis of one year's duration ultimately proved to be the result of malignant lymphoma. After resolution of swelling and ptosis with chemotherapy, the patient returned with diffuse iris involvement and uveitis with a hypopyon. In the second patient an acute change of refractive error proved to be the result of a lymphomatous deposit in the choroid. In both instances common symptoms were the initial manifestations of a diffuse malignant disease.