Sauer Theodor C, Meyers Sanford M, Shen Defen, Vegh Sara, Vygantas Charles, Chan Chi-Chao
From the *Immunopathology Section, Laboratory of Immunology, National Eye Institute, National Institutes of Health, Bethesda, Maryland; †Retina Consultants, Des Plaines, Illinois; and ‡Retina Consultants, Libertyville, Illinois.
Retin Cases Brief Rep. 2010 Spring;4(2):160-3. doi: 10.1097/ICB.0b013e3181ad3916.
Toxoplasmosis gondii is a common worldwide parasite that presents in the eye with focal retinochoriditis and vitritis. Although it is rare, ocular toxoplasmosis has been linked to primary intraocular (retinal) lymphoma, which is mostly a diffuse large B-cell lymphoma.
An elderly female patient was treated for recurrent ocular toxoplasmosis, and because of progressive vitritis, a diagnostic vitrectomy was performed. Shortly afterward, she developed multiple brain lesions. Pathologic examinations of the vitreous specimen and cerebral tissues were conducted, including tests for T. gondii, Epstein-Barr virus, and cytomegalovirus DNA.
The patient initially responded to antitoxoplasmosis treatment but continued to have persistent vitritis. She was diagnosed with primary intraocular lymphoma, and a repeated magnetic resonance imaging revealed cerebral lesions. Brain biopsy confirmed lymphoma. T. gondii DNA was found in malignant vitreous cells but was absent in the nonmalignant vitreous cells and brain lymphoma cells. The cytomegalovirus and Epstein-Barr virus genes were not found in any of the lymphoma cells.
T. gondii may have played a role in lymphoproliferation and primary intraocular lymphoma development.
刚地弓形虫是一种全球常见的寄生虫，可在眼部表现为局灶性视网膜脉络膜炎和玻璃体炎。虽然罕见，但眼部弓形虫病已被认为与原发性眼内（视网膜）淋巴瘤有关，后者大多为弥漫性大B细胞淋巴瘤。
一名老年女性患者因复发性眼部弓形虫病接受治疗，由于玻璃体炎进展，进行了诊断性玻璃体切除术。此后不久，她出现了多处脑部病变。对玻璃体标本和脑组织进行了病理检查，包括检测弓形虫、EB病毒和巨细胞病毒DNA。
患者最初对抗弓形虫病治疗有反应，但玻璃体炎持续存在。她被诊断为原发性眼内淋巴瘤，重复磁共振成像显示脑部有病变。脑活检证实为淋巴瘤。在恶性玻璃体细胞中发现了弓形虫DNA，但在非恶性玻璃体细胞和脑淋巴瘤细胞中未发现。在任何淋巴瘤细胞中均未发现巨细胞病毒和EB病毒基因。
弓形虫可能在淋巴细胞增殖和原发性眼内淋巴瘤的发生中起作用。
