Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0079731 (B-cell lymphoma)
 16,671 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Intraocular lymphoma is a rare ocular malignancy that may occur in the retina or the uvea. Retina or vitreoretinal lymphoma accounts for the majority of cases and is often secondary to diffuse large B-cell lymphoma. In the present study, a 66-year-old Caucasian male with a history of Waldenstrom's macroglobulinemia with diffuse large B-cell lymphoma, presented with blurred vision in the left eye one month following cycle 4 of an R-CHOP regimen. At the time of onset, the patient was being treated for bacterial pneumonia. Visual acuity was 20/25 in his right eye (OD) and 20/30 in the left (OS). Ophthalmologic examination showed intraretinal white infiltrates associated with hemorrhage in the superotemporal midperiphery of the retina and vitritis OS. Initial diagnostic considerations included infectious (cytomegalovirus retinitis, syphilis, toxoplasmosis, tuberculosis), inflammatory (retinal vasculitis associated with autoimmune disease or hypercoagulable states) or malignant (intraocular lymphoma) diseases. The patient did not respond to intravitreal injection of foscarnet and oral valgancyclovir. Systemic work-up and aqueous fluid biopsy were inconclusive. Diagnostic vitrectomy yielded inconclusive results and the patient continued to have progressive loss of vision. A repeat diagnostic vitrectomy with retinal and subretinal biopsy confirmed large B cells consistent with metastatic B-cell lymphoma. A concomitant PET/CT scan was performed that revealed bilateral new pulmonary nodules resulting in additional chemotherapy. Our case shows the diagnostic dilemmas in patients with systemic lymphoma and the possible role of concurrent systemic restaging in patients with ocular complaints, even when in systemic remission.
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PMID:Metastatic B-cell lymphoma masquerading as infectious retinitis and vasculitis. 2278 26

Primary vitreoretinal lymphoma (PVRL) can be a diagnostic challenge and commonly presents as a partially steroid-responsive vitritis or as subretinal cream-colored infiltrates. The authors present a patient with PVRL who initially presented with bilateral vitritis; however, after two non-diagnostic vitrectomy specimens and two unremarkable brain MRIs, she was lost to follow-up. She presented 2.5 years later with a white plaque on the posterior capsule of her left intraocular lens, though the vitreous cavity was free of infiltrate. Repeat biopsy revealed diffuse large B-cell lymphoma, and brain MRI demonstrated an enhancing lesion of the cerebellum, consistent with primary central nervous system lymphoma.
Ophthalmic Surg Lasers Imaging Retina 2018 09 01
PMID:Primary Vitreoretinal Lymphoma Presenting as a Posterior Capsule Plaque. 3022 12