Kubicka-Trzaska Agnieszka, Gedliczka Monika, Romanowska-Dixon Bozena
Z Kliniki Okulistyki i Onkologii Okulistycznej Katedry Okulistyki, Uniwersytetu Jagiellońskiego Collegium Medicum w Krakowie.
Klin Oczna. 2010;112(10-12):314-7.
To report a rare case of a masquerading syndrome in a course of chronic lymphocytic leukemia (CLL).
A 57 years old woman with bilateral lacrimal glands enlargement and chronic uveitis unresponsive to local steroids, was studied. Patient's general history was positive for chronic lymphocytic leukemia, B cell (B-CLL); actually remission. The patient underwent complete ophthalmic examination with additional A and B-scan ultrasonography (USG), computed tomography (CT) and nuclear magnetic resonance (NMR) imaging of orbital cavities and also biopsy of both lacrimal glands was performed.
USG, CT and NMR scans revealed the intraocular inflammation and inflammatory enlargement of both lacrimal glands. The histopathological examination of lacrimal glands showed the presence of lymphocytic infiltrations within the glands' tissue. The patient started with chemotherapy: Fludarabin and Cyclophosphamide. Within weeks the intraocular inflammation was under control and the resolution of lacrimal glands edema was noted.
Malignancy should be considered in cases of chronic uveitis that do not respond to steroid therapy. Chronic lymphocytic leukemia rarely masks as chronic intraocular inflammation, in a sporadic cases however it may herald the relapse of the disease.
报告1例慢性淋巴细胞白血病（CLL）病程中出现伪装综合征的罕见病例。
研究1例57岁女性患者，其双侧泪腺肿大且慢性葡萄膜炎对局部类固醇治疗无反应。患者既往史显示慢性淋巴细胞白血病B细胞型（B - CLL）呈阳性，目前处于缓解期。对患者进行了全面的眼科检查，包括额外的A和B超超声检查（USG）、眼眶计算机断层扫描（CT）和核磁共振（NMR）成像，并对双侧泪腺进行了活检。
USG、CT和NMR扫描显示眼内炎症及双侧泪腺炎性肿大。泪腺组织病理学检查显示腺体内存在淋巴细胞浸润。患者开始接受化疗：氟达拉滨和环磷酰胺。数周内眼内炎症得到控制，泪腺水肿消退。
对于对类固醇治疗无反应的慢性葡萄膜炎病例，应考虑恶性肿瘤的可能。慢性淋巴细胞白血病很少伪装为慢性眼内炎症，但在散发病例中，它可能预示疾病复发。
