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. 2022 Nov 14;4(20):CASE22340.
doi: 10.3171/CASE22340. Print 2022 Nov 14.

Primary non-Hodgkin lymphoma of the chiasm and optic tract in a nonimmunocompromised patient: illustrative case

Hassan Kadri  1 , Ghiath Hamed  2 , Anas Anbari  3
Affiliations

Primary non-Hodgkin lymphoma of the chiasm and optic tract in a nonimmunocompromised patient: illustrative case

Hassan Kadri et al. J Neurosurg Case Lessons. .

Abstract

Background: Chiasmatic and optic track lymphoma as the primary lesion of the central nervous system (CNS) is extremely rare.

Observations: The authors report a case of a previously healthy 62-year-old woman who presented with quick and progressive visual impairment leading to bilateral blindness. Brain imaging studies suggested glioma or lymphoma of the chiasm and the posterior visual pathway. Postoperative examination revealed low-grade malignant B-cell lymphoma. No evidence of extracranial lymphoma was found, so a final diagnosis of primary CNS lymphoma (PCNSL) was made.

Lessons: To the authors' knowledge, PCNSL confined to the optic chiasm has rarely been reported in nonimmunocompromised patients. The present case of lymphoma affecting the optic chiasm and optic tract is extremely rare.

Keywords: chiasmatic involvement; non-Hodgkin lymphoma; optic nerve involvement; primary central nervous system lymphoma.

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Conflict of interest statement

Disclosures The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

Figures

FIG. 1.
FIG. 1.
Coronal (left) and axial (right) postcontrast T1-weighted MRI showing mass lesions with homogeneous enhancement of the optic tracts involving the chiasm with slight enhancement of the infundibulum.
FIG. 2.
FIG. 2.
Fundus edema with suspected bilateral partial axonal loss of the optic nerves. IR = infrared; OD = right eye; OS = left eye; RNFL = retinal nerve fiber layer.
FIG. 3.
FIG. 3.
A: Hematoxylin and eosin stain shows aggregates of small lymphocytes. B: Perivascular lymphoid infiltration. C: Immunostain for CD20 marker shows positive staining. D: CD3 marker stains few small lymphocytes in the background. E: CD5 marker positive in the majority of lymphocytes. F: Ki-67 proliferative marker shows low proliferation activity. Original magnification ×400 (A, C, and D) and ×100 (B, E, and F).
See this image and copyright information in PMC

References

    1. Armitage JO, Gascoyne RD, Lunning MA, Cavalli F. Non-Hodgkin lymphoma. Lancet. 2017;390(10091):298–310. - PubMed
    1. Corn BW, Marcus SM, Topham A, Hauck W, Curran WJ., Jr Will primary central nervous system lymphoma be the most frequent brain tumor diagnosed in the year 2000? Cancer. 1997;79(12):2409–2413. - PubMed
    1. Eby NL, Grufferman S, Flannelly CM, Schold SC, Jr, Vogel FS, Burger PC. Increasing incidence of primary brain lymphoma in the US. Cancer. 1988;62(11):2461–2465. - PubMed
    1. Tatsugawa M, Noma H, Mimura T, Funatsu H. Unusual orbital lymphoma undetectable by magnetic resonance imaging: a case report. J Med Case Rep. 2009;3:104. - PMC - PubMed
    1. Kim UR, Shah AD, Arora V, Solanki U. Isolated optic nerve infiltration in systemic lymphoma—a case report and review of literature. Ophthal Plast Reconstr Surg. 2010;26(4):291–293. - PubMed

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