[Malignant intraocular non-Hodgkin's lymphoma]

Abstract

The authors presented two personal cases of ocular involvement by non hodgkin's malignant lymphomas. The first one concerned a 55 year-old man; initial symptoms were oedematous optic neuropathy associated to vitritis, uveitis and chorio-retinal infiltrates. The ocular symptoms did not respond to cortico-steroid therapy and lymphoma was diagnosed eight months later by histologic examination of a cerebral tumor discovered by C.T. scan. Systemic examination was normal. In spite of a cerebral radiotherapy associated to chemotherapy, uveitis and vitritis occurred in the other eye and vitreous biopsy of the most affected eye showed no cell abnormalities. The patient died two years after the onset of ocular symptoms. The second case concerned a 67 year-old woman who presented an association of absolute glaucoma secondary to uveitis with retinal detachment and neurological symptoms due to a cerebral tumor detected by C.T. Scan. Histological examination of the enucleated eye confirmed the diagnosis of centroblastic lymphoma: choroid, retina and optic nerve were involved. A data review consisted of a study of 93 cases with the same pathological conditions and permitted a discussion about the main clinical features of this affection and the different histological aspects. The following classification of the different forms of ocular lymphomas was proposed: isolated associated to cerebral and/or to systemic localizations. The management of a treatment by radiotherapy was discussed, based on the previous reports, and a prognosis of oculo-cerebral lymphomas was given.