Abe Ricardo Yuji, Pinto Roberto Damian Pacheco, Bonfitto João Felipe Leite, Lira Rodrigo Pessoa Cavalcanti, Arieta Carlos Eduardo Leite
Departamento de Oftalmologia, Hospital de Clínicas, Universidade Estadual de Campinas - UNICAMP, Campinas, SP, Brazil.
Arq Bras Oftalmol. 2012 Nov-Dec;75(6):430-2. doi: 10.1590/s0004-27492012000600013.
A 33-year-old woman complained of unilateral eyelid edema and blurred vision. Initial ophthalmic examination disclosed anterior chamber reaction with keratic precipitates on the cornea, without posterior abnormalities. Anterior uveitis was treated. Despite that, patient showed rapidly progressive unilateral vision loss with optic nerve swelling. Systemic workup was inconclusive, as well as cranial magnetic resonance imaging and cerebrospinal fluid examination. Based on the hypothesis of optic neuritis, intravenous methylprednisolone pulse was performed with no success. During the following days, the patient presented pericardial effusion and cardiac tamponade, progressing to death. Necropsy was performed and diagnosis of extranodal natural killers/T-cell lymphoma, nasal type with ocular involvement was confirmed by immunohistochemistry.
一名33岁女性主诉单侧眼睑水肿和视力模糊。初次眼科检查发现前房反应,角膜有角膜后沉着物,后部无异常。前葡萄膜炎接受了治疗。尽管如此,患者仍出现快速进展的单侧视力丧失和视神经肿胀。全身检查、头颅磁共振成像和脑脊液检查均无定论。基于视神经炎的假设,进行了静脉注射甲泼尼龙冲击治疗,但未成功。在接下来的几天里,患者出现心包积液和心脏压塞,最终死亡。进行了尸检,免疫组化确诊为鼻型结外自然杀伤/T细胞淋巴瘤伴眼部受累。