Reid Jonathan P, Puglis Christie L, Slagle William Scott
*OD †OD, FAAO Salem Veterans Affairs Medical Center, Salem, Virginia (JPR, WSS); Wing Eyecare, Cincinnati, Ohio (CLP); and Virginia Tech Carilion School of Medicine, Roanoke, Virginia (WSS).
Optom Vis Sci. 2014 Apr;91(4 Suppl 1):S25-9. doi: 10.1097/OPX.0000000000000218.
Non-Hodgkin lymphoma (NHL) is a neoplastic process of the lymphatic system in which tumors develop from lymphocytes. The absence of Reed-Sternberg cells differentiates NHL from Hodgkin lymphoma (HL). Mantle cell lymphoma is a mature B-cell NHL, typically with an aggressive course. Manifestations of intraocular mantle cell lymphoma include anterior uveitis, morphologic changes to the uvea, vitritis, intraocular masses, as well as subretinal or choroidal infiltrates.
A 71-year-old white man with known mantle cell lymphoma presents with recent-onset blurred vision in the left eye resulting from an atypical anterior chamber cellular reaction. Iris examination reveals topographic and morphologic atypia suggestive of neoplasia. He subsequently developed posterior cervical lymph node involvement indicating recurrence of his mantle cell lymphoma. He was restarted on chemotherapy and radiation. The iris and anterior chamber reaction responded to systemic oncological therapy.
Mantle cell lymphoma may present with ocular manifestations such as an anterior chamber cellular reaction and morphologic changes to the uvea. This case stresses the importance of seeking an etiology in any secondary or atypical uveitis.
非霍奇金淋巴瘤(NHL)是一种淋巴系统的肿瘤性病变,肿瘤由淋巴细胞发展而来。里德-斯特恩伯格细胞的缺失将NHL与霍奇金淋巴瘤(HL)区分开来。套细胞淋巴瘤是一种成熟B细胞NHL,通常病程侵袭性强。眼内套细胞淋巴瘤的表现包括前葡萄膜炎、葡萄膜形态改变、玻璃体炎、眼内肿物以及视网膜下或脉络膜浸润。
一名71岁已知患有套细胞淋巴瘤的白人男性,因非典型前房细胞反应导致近期左眼视力模糊就诊。虹膜检查发现提示肿瘤形成的地形学和形态学异常。随后他出现颈后淋巴结受累,提示套细胞淋巴瘤复发。他重新开始接受化疗和放疗。虹膜和前房反应对全身肿瘤治疗有反应。
套细胞淋巴瘤可能表现为眼前房细胞反应和葡萄膜形态改变等眼部表现。该病例强调了在任何继发性或非典型葡萄膜炎中寻找病因的重要性。