Cursiefen C, Holbach L M, Lafaut B, Heimann K, Kirchner T, Naumann G O
Department of Ophthalmology, Friedrich-Alexander-University Erlangen-Nürnberg, Schwabachanlage 6, 91054 Erlangen, Germany.
Arch Ophthalmol. 2000 Oct;118(10):1437-40. doi: 10.1001/archopht.118.10.1437.
Primary ocular lymphoma is the ocular manifestation of primary oculocerebral non-Hodgkin's lymphoma. We describe a 79-year-old woman with a 7-year history of bilateral uveitis and subsequent central nervous system lymphomas. Repeated diagnostic vitrectomy during the following 5 years failed to demonstrate intraocular lymphoma cells. Within 9 months after the second vitrectomy, an epibulbar tumor developed in the limbal region of the left eye at the site of the sclerotomy. The eye, blind and painful due to secondary angle-closure glaucoma, was enucleated. Histopathologically, the globe showed a diffuse large B-cell non-Hodgkin's lymphoma extending from the ciliary body outward through the sclerotomy. We conclude that, following vitrectomy, a primary ocular lymphoma may extend through the sclerotomy lesion and present as an epibulbar tumor. Uveal involvement may occur in oculocerebral non-Hodgkin's lymphoma.
原发性眼内淋巴瘤是原发性眼脑非霍奇金淋巴瘤的眼部表现。我们描述了一位79岁女性，有7年双侧葡萄膜炎病史，随后发生中枢神经系统淋巴瘤。在接下来的5年中，多次诊断性玻璃体切除术均未发现眼内淋巴瘤细胞。第二次玻璃体切除术后9个月内，左眼角膜缘区域巩膜切开处出现球结膜下肿瘤。由于继发性闭角型青光眼，该眼失明且疼痛，遂行眼球摘除术。组织病理学检查显示，眼球有弥漫性大B细胞非霍奇金淋巴瘤，从睫状体向外延伸穿过巩膜切开处。我们得出结论，玻璃体切除术后，原发性眼内淋巴瘤可能通过巩膜切开处病变扩展并表现为球结膜下肿瘤。眼脑非霍奇金淋巴瘤可能累及葡萄膜。
