Yoo Jae Ho, Kim Soo Young, Jung Kyu Bong, Lee Jung Joo, Lee Sang Joon
Department of Ophthalmology, Kosin University College of Medicine, Busan, Korea.
Korean J Ophthalmol. 2012 Feb;26(1):54-7. doi: 10.3341/kjo.2012.26.1.54. Epub 2012 Jan 14.
Herein, we report a case of nasal natural killer T-cell lymphoma (NKTL) with intraocular involvement. A 57-year-old woman was referred due to a three-day history of photophobia and diplopia in the left eye. One-month previously, she was diagnosed with nasal NKTL of the right nasal cavity. Ophthalmic examination revealed conjunctival injection and ptosis. The left pupil was fully dilated and non-reactive to light. Ocular motion was restricted on left-upper gaze. Five days later, anterior uveitis developed and persisted despite topical steroid treatment. An orbital magnetic resonance imaging was without specific findings, however, ophthalmoplegia, vitreous opacity, and an iris mass were observed. A diagnostic anterior chamber aspiration was performed. Aqueous humor aspiration revealed 35% morphologically atypical lymphocytes. After an intravitreal triamcinolone injection, radiotherapy and chemotherapy were administered; this resolved the uveitis and iris mass. When refractory uveitis or orbital pseudotumor occurs in patients with nasal NKTL, ocular and orbital involvement of the NKTL should be considered.
在此,我们报告一例伴有眼内受累的鼻型自然杀伤T细胞淋巴瘤(NKTL)。一名57岁女性因左眼畏光和复视3天前来就诊。1个月前,她被诊断为右侧鼻腔鼻型NKTL。眼科检查发现结膜充血和上睑下垂。左侧瞳孔完全散大,对光无反应。左上注视时眼球运动受限。5天后,尽管局部使用类固醇治疗,前葡萄膜炎仍发生并持续存在。眼眶磁共振成像未发现特异性表现,然而,观察到眼球运动障碍、玻璃体混浊和虹膜肿物。进行了诊断性前房穿刺。房水抽吸显示35%形态学上不典型淋巴细胞。玻璃体内注射曲安奈德后,给予放疗和化疗;这使葡萄膜炎和虹膜肿物得到缓解。当鼻型NKTL患者出现难治性葡萄膜炎或眼眶假瘤时,应考虑NKTL的眼内和眼眶受累情况。