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OPHTHALMIC IMAGE |
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Year : 2019 | Volume
: 67
| Issue : 2 | Page : 275 |
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Bilateral vitritis as an initial presentation of primary central nervous system lymphoma
Nitin K Menia1, Ranjan Behera1, Reema Bansal1, Nalini Gupta2, Astha Takkar3, Vivek Lal3
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 Publication | 23-Jan-2019 |
Correspondence Address: Dr. Reema Bansal Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh - 160 012 India
Source of Support: None, Conflict of Interest: None | Check |
DOI: 10.4103/ijo.IJO_773_18
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 |
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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Conflicts of interest
There are no conflicts of interest.
References | | |
1. | Korfel A, Schlegel U. Diagnosis and treatment of primary CNS lymphoma. Nat Rev Neurol 2013;9:317-27. |
2. | Buggage RR, Chan CC, Nussenblatt RB. Ocular manifestations of central nervous system lymphoma. Curr Opin Oncol 2001;13:137-42. |
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. |
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. |
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. |
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