Wills Eye Institute, Thomas Jefferson University, USA.
Ophthalmic Plast Reconstr Surg. 2011 Sep-Oct;27(5):e134-6. doi: 10.1097/IOP.0b013e31820367e1.
A 43-year-old Asian man with idiopathic CD4+ lymphocytopenia (human immunodeficiency virus [HIV]-negative acquired immunodeficiency syndrome [AIDS]) noted blurred vision OD. Visual acuity was 20/30 OD and 20/15 OS. The right eye showed features of axial proptosis (2 mm), blepharoptosis, upgaze restriction, conjunctival chemosis, color desaturation, and choroidal folds. The OS was unremarkable. There was no lymphadenopathy. Orbital MRI showed a well-circumscribed mass indenting the globe. Excision revealed diffuse large-B-cell lymphoma. Systemic evaluation was negative and adjuvant external beam radiotherapy to the right orbit was performed. Idiopathic CD4+ lymphocytopenia is a rare hematologic condition characterized by depletion of CD4+ T cells in HIV-negative patients. This condition closely resembles AIDS but HIV serology is negative. Similar to AIDS, patients are at risk for opportunistic infections and neoplasia, including systemic lymphoma. This is the first case, to the authors' knowledge, of orbital lymphoma with idiopathic CD4+ lymphocytopenia.
一位 43 岁的亚裔男性，患有特发性 CD4+ 淋巴细胞减少症（HIV 阴性获得性免疫缺陷综合征 [AIDS]），出现右眼视力模糊。右眼视力为 20/30，左眼视力为 20/15。右眼表现为眼球突出（2 毫米）、眼睑下垂、上视受限、结膜水肿、颜色褪色和脉络膜皱褶。左眼无异常。无淋巴结病。眼眶 MRI 显示边界清楚的肿块使眼球受压。切除后显示弥漫性大 B 细胞淋巴瘤。全身评估为阴性，并对右眼进行了辅助外部束放疗。特发性 CD4+ 淋巴细胞减少症是一种罕见的血液学疾病，其特征是 HIV 阴性患者中 CD4+ T 细胞耗竭。这种情况与艾滋病非常相似，但 HIV 血清学检测为阴性。与艾滋病一样，患者有机会性感染和肿瘤的风险，包括全身淋巴瘤。据作者所知，这是首例特发性 CD4+ 淋巴细胞减少症伴眼眶淋巴瘤的病例。
