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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 2024 Mar 28];67:275. Available from: https://journals.lww.com/ijo/pages/default.aspx/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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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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