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Case Reports
. 2016 Jun;32(Suppl 1):143-7.
doi: 10.1007/s12288-015-0599-x. Epub 2015 Sep 20.

Primary Intraocular Diffuse Large B-cell Lymphoma: Diagnostic Difficulties in Deep Retinal Infiltrations with Vitritis

Katarzyna Kapelko-Slowik  1 , Donata Urbaniak-Kujda  2 , Anna Turno-Krecicka  3 , Stanislaw Potoczek  1 , Jaroslaw Dybko  1 , Monika Biernat  4 , Miroslaw Slowik  3
Affiliations
Case Reports

Primary Intraocular Diffuse Large B-cell Lymphoma: Diagnostic Difficulties in Deep Retinal Infiltrations with Vitritis

Katarzyna Kapelko-Slowik et al. Indian J Hematol Blood Transfus. 2016 Jun.

Abstract

Purpose: Primary intraocular lymphoma (PIOL) is a rare malignancy with an aggressive clinical course. It is usually considered as a subset of primary central nervous system lymphoma. Differential diagnosis should include infectious and non-infectious aetiologies, particularly the common masqueraders sarcoidosis, tuberculosis, viral retinitis and syphilis.

Patient: The article presents a case of bilateral vitreoretinal lymphoma manifesting as uveitis and vitritis resistant to corticosteroid therapy. The final diagnosis was based on a retinal biopsy.

Results: The patient was successfully treated with systemic and local therapy. Long-term complete remission (CR) was reached. The relapse of diffuse large B-cell lymphoma was revealed in the frontal left lobe after 48 months of CR duration.

Conclusion: The diagnosis of PIOL is always very difficult. Cooperation of pathologists, ophthalmologists and hematologists is required for a quick and accurate diagnosis. Local and systemic treatment is needed to achieve CR, but the relapse rate remains very high.

Keywords: Chemotherapy; Lymphoma; Retinal infiltration; Uveitis; Vitritis.

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Figures

Fig. 1
Fig. 1
January 2009. Fundus photography: right eye (RE) normal fundus, left eye (LE) retinal deep infiltrations near lower temporal vascular arcade, macular oedema, vitritis
Fig. 2
Fig. 2
a March 2009. Fundus photography: right eye (RE): retinal infiltrations around lower temporal arcade, small retinal hemorrhages near vessels. b March 2009. Fundus photography: left eye (LE) after diagnostic vitrectomy with silicon oil tamponade, infiltration of the optic nerve head, with surrounding hemorrhages, typical white deep retinal changes with patchy pigmentation
Fig. 3
Fig. 3
December 2009. Fundus photography after chemotherapy: normal posterior pole of the right eye (RE), in the left eye (LE) fibrotic changes around the optic nerve head
Fig. 4
Fig. 4
January 2014. Brain`s MRI: a tumour in the frontal left lobe with oedema of the brain tissue
See this image and copyright information in PMC

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