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   Table of Contents      
OPHTHALMIC IMAGE
Year : 2019  |  Volume : 67  |  Issue : 2  |  Page : 275

Bilateral vitritis as an initial presentation of primary central nervous system lymphoma


1 Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
2 Department of Cytology and Gynecological Pathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
3 Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India

Date of Web Publication23-Jan-2019

Correspondence Address:
Dr. Reema Bansal
Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh - 160 012
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_773_18

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How to cite this article:
Menia NK, Behera R, Bansal R, Gupta N, Takkar A, Lal V. Bilateral vitritis as an initial presentation of primary central nervous system lymphoma. Indian J Ophthalmol 2019;67:275

How to cite this URL:
Menia NK, Behera R, Bansal R, Gupta N, Takkar A, Lal V. Bilateral vitritis as an initial presentation of primary central nervous system lymphoma. Indian J Ophthalmol [serial online] 2019 [cited 2019 Sep 21];67:275. Available from: http://www.ijo.in/text.asp?2019/67/2/275/250681



A 75-year-old male with 6/36 vision (both eyes) for 6 months had few keratic precipitates and dense vitritis precluding fundus details [Figure 1]a and [Figure 1]b. Following vitrectomy in left eye, vitreous cytology and immunocytochemistry confirmed B-cell non-Hodgkin's lymphoma [Figurre 1]c. Brain MRI showed focal lesions in parafalcine region of left frontal lobe [Figure 1]d. Cerebrospinal fluid (CSF) cytology confirmed central nervous system (CNS) lymphoma. He received intravitreal and systemic chemotherapy, with no recurrence at 10-month follow-up. Primary vitreoretinal lymphoma should be suspected in cases with first episode of uveitis in an elderly patient, dense vitritis, without posterior synechiae, or macular edema.[1],[2],[3],[4],[5]
Figure 1: Right (a) and left (b) eye wide-field fundus photographs *** showing dense vitritis. Following diagnostic vitrectomy, cytological examination of the vitreous fluid samples showed lymphoma cells (c), and immunocytochemistry stains showed CD-20-positive cells suggestive of B-cell lymphoma (inset). Brain MRI showed focal lesions in parafalcine region of left frontal lobe (d)

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Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Korfel A, Schlegel U. Diagnosis and treatment of primary CNS lymphoma. Nat Rev Neurol 2013;9:317-27.  Back to cited text no. 1
    
2.
Buggage RR, Chan CC, Nussenblatt RB. Ocular manifestations of central nervous system lymphoma. Curr Opin Oncol 2001;13:137-42.  Back to cited text no. 2
    
3.
Qualman SJ, Mendelsohn G, Mann RB, Green WR. Intraocular lymphomas: natural history based on clinicopathologic study of eight cases and reviews of the literature. Cancer 1983;52:878-86.  Back to cited text no. 3
    
4.
Akpek EK, Ahmed I, Hochberg FH, Soheilian M, Dryja TP, Jakobiec FA, et al. Intraocular-central nervous system lymphoma: Clinical features, diagnosis and outcome. Ophthalmology 1999;106:1805-10.  Back to cited text no. 4
    
5.
Katoch D, Bansal R, Nijhawan R, Gupta A. Primary intraocular central nervous system lymphoma masquerading as diffuse retinal vasculitis. BMJ Case Rep 2013;2013. doi: 10.1136/bcr-2013-009354.  Back to cited text no. 5
    


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