Hanamura A, Maeda H, Kuwayama W, Takano Y
Department of Internal Medicine, Chita Municipal Hospital.
Rinsho Ketsueki. 1992 Dec;33(12):1845-50.
An 80-year-old male was admitted to our hospital because of multiple tumors in October 1989. A pathological diagnosis of non-Hodgkin's lymphoma (diffuse, medium-sized cell type) was made with the histological examination of his biopsied tumors. His clinical stage was stage IV A. Chemotherapy (CHOP) brought him to complete remission. In May 1990, relapse of non-Hodgkin's lymphoma was observed in the neck and both eyes. The diagnosis of uveitis due to involvement of lymphoma cells was confirmed by an aspiration biopsy of left aqueous humor. Complete recovery of his visual acuity was possible with additional chemotherapy, and lymphoma cells in his right aqueous humor were expelled completely, while his cervical tumor remained 1/3 of the original size. He eventually died of pneumonia on December 9th, 1990. Intraocular involvement of malignant lymphoma is rare in comparison with extraocular involvement. Especially, the patient who has only turbid aqueous humor as an ophthalmic sign is very rare. In this paper, we reported a case of lymphoma with intraocular involvement and discussed the mechanisms of infiltration of lymphoma cells into the aqueous humor and the therapy.
一名80岁男性于1989年10月因多发肿瘤入住我院。对其活检肿瘤进行组织学检查后，病理诊断为非霍奇金淋巴瘤（弥漫性，中等大小细胞型）。其临床分期为IV A期。化疗（CHOP方案）使其达到完全缓解。1990年5月，在颈部和双眼观察到非霍奇金淋巴瘤复发。通过对左眼房水进行穿刺活检，证实了因淋巴瘤细胞浸润导致的葡萄膜炎诊断。额外的化疗使他的视力完全恢复，右眼房水中的淋巴瘤细胞被完全清除，而颈部肿瘤仍为原来大小的1/3。他最终于1990年12月9日死于肺炎。与眼外受累相比，恶性淋巴瘤的眼内受累较为罕见。特别是，仅以房水混浊作为眼部体征的患者非常罕见。在本文中，我们报告了一例伴有眼内受累的淋巴瘤病例，并讨论了淋巴瘤细胞浸润房水的机制及治疗方法。
