[Intraocular lymphoma--a clinical study of 14 patients with non-Hodgkin's lymphoma]

Abstract

Aim: To evaluate the course of clinical picture of intraocular lymphoma, possibilities of examination of this disease and the association with general symptoms of the non-Hodgkin lymphoma (NHL) in patients with manifestations of uveitis.

Patients and methods: A retrospective study in 14 patients followed in the period of 1996-2001 in the Center for Diagnostics and Therapy of Uveitis, Ocular Clinic of General Faculty Hospital and 1st Medical Faculty, Charles University in Prague.

Results: The group included 7 women and 7 men at the average age of 57.3 years (18-82) with clinical picture of uveitis. The time period from the first symptoms to the diagnosis of NHL was 5-38 months (mean, 14.6 month). In two patients the diagnosis of systemic NHL preceded ocular symptoms, in four other patients the diagnosis of systemic or central nervous system NHL (CNS NHL) was established during ocular manifestations of uveitis. Intraocular lymphoma was the only first manifestation of CNS NHL in six patients for the period of 9-34 months (mean, 15.2). Two patients have been so far affected by primary intraocular lymphoma (PIL) for 8 and 14 months respectively, and presently do not display any signs of systemic or CNS NHL. Clinical signs of intraocular inflammation of both eyes were encountered in 71.4% of patients. Vitritis (85.7%) and tumor infiltration of retina (65.3%) were the most frequent manifestations of NHL. Intraocular NHL was diagnosed on the basis of cytological examination of samples of intraocular fluids in 8 patients (57.1%). In four patients radiotherapy was applied onto 5 eyes and in 5 patients radiotherapy of CNS was used. Nine patients were treated with chemotherapy. 50% of patients died until the end of 2001, the survival from the establishment of diagnosis was 20.6 months on the average.

Conclusions: Intraocular lymphoma should be considered as the eye and life-threatening disease. Cytological examination of intraocular fluids in patients with uveitis who do not respond to the therapy with steroids in the usual way may give more precision and shorten the establishment of diagnosis in this masquerade syndrome. Early diagnosis and therapy may improve the prognosis of NHL.