A case of intravascular lymphoma diagnosed with a primary vitreoretinal lymphoma-like fundus lesion

Journal of Ophthalmic Inflammation and Infection

Yasunori Ishibashi¹  Hiroshi Yamaguchi¹  Masahide Gondo²  Daigo Akahane³  Masaki Asakage⁴  Kazuhiko Umazume⁴  Hiroshi Goto⁴  Hiroyuki Takoi⁵ 

[1] Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan;Department of Dermatology, Tokyo Medical University, Tokyo, Japan;Department of Hematology, Tokyo Medical University, Tokyo, Japan;Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, 160-00023, Tokyo, Japan;Department of Respiratory Medicine, Tokyo Medical University, Tokyo, Japan;

关键词: INTRAVASCULAR lymphoma;    Vitreoretinal lymphoma;   

DOI  :  10.1186/s12348-021-00280-0

来源: Springer

【 摘 要 】

PurposeWe report a case of intravascular lymphoma with primary vitreoretinal lymphoma-like fundus findings.CaseA 61-year-old man with a one-week history of temporal visual field defect in the left eye was referred by a local ophthalmologist to our department. A yellowish-white raised patchy lesion was found in the nasal fundus of the left eye. Vitreoretinal lymphoma was suspected, and vitrectomy was performed in the left eye for diagnostic purpose. However, vitreous interleukin-10 concentration was low and no significant result was obtained. He had fever of around 38 °C, and respiratory failure that started 2 weeks before ophthalmological examination, worsened. Intravascular lymphoma was diagnosed from the results of histopathological examinations of transbronchial lung biopsy, bone marrow biopsy and random skin biopsy. With the start of systemic chemotherapy, the subretinal lesions shrank gradually and systemic condition was stable. However, 5 months after the start of chemotherapy, spread to the central nervous system was observed, and chimeric antigen receptor T cell (CAR-T) therapy was started in another hospital. After the start of CAR-T therapy, the subretinal lesions shrank further.ConclusionsIntravascular lymphoma may be accompanied by primary vitreoretinal lymphoma-like intraocular lesions. If intraocular lesions are accompanied by systemic symptoms such as fever of unknown origin, the possibility of intravascular lymphoma should be suspected and systemic work-up should be performed.

【 授权许可】

CC BY