Casswell Edward J, Pringle Edward, Thuang Caroline, Sanders Mike D, Graham Elizabeth M
a Western Eye Hospital , London , UK .
b Kings College Hospital , London , UK .
Ocul Immunol Inflamm. 2016 Oct;24(5):503-7. doi: 10.3109/09273948.2015.1012296. Epub 2015 Jul 14.
Paraneoplastic ocular inflammation can be associated with the autoantibody against collapsin response-mediator protein-5 (anti-CRMP-5). We describe the clinical and histological features of 2 rare cases of small cell lung carcinoma (SCLC) presenting with intraocular inflammation: the first was anti-CRMP-5 positive and the second preceded the auto-antibody's discovery but with remarkably similar features. The previously unreported retinal histology is described.
Case notes review.
Both cases presented with bilateral visual loss, constricted visual fields, vitritis, and pale, swollen optic discs. Fundal fluorescein angiographies showed optic disc leakage. Retinal histology of both cases revealed predominantly inner retinal inflammation. Following their diagnosis with SCLC, serology for case 1 was positive for anti-CRMP-5 but case 2 pre-dated its discovery.
CRMP-5 inflammatory eye disease presents with a distinct pattern of clinical and histological features, which may be the first sign of their underlying cancer. Retinal histology revealed predominantly inner retinal inflammation.
副肿瘤性眼部炎症可能与抗塌陷反应介导蛋白5自身抗体(抗CRMP-5)相关。我们描述了2例表现为眼内炎症的小细胞肺癌(SCLC)罕见病例的临床和组织学特征:第一例抗CRMP-5阳性,第二例在自身抗体发现之前出现,但具有明显相似的特征。描述了此前未报告的视网膜组织学情况。
病例记录回顾。
两例均表现为双侧视力丧失、视野缩窄、玻璃体炎以及视盘苍白、肿胀。眼底荧光血管造影显示视盘渗漏。两例的视网膜组织学均显示主要为视网膜内层炎症。在诊断为SCLC后,病例1的血清学检查抗CRMP-5呈阳性,但病例2在其发现之前就已出现。
CRMP-5炎性眼病呈现出独特的临床和组织学特征模式,这可能是其潜在癌症的首个迹象。视网膜组织学显示主要为视网膜内层炎症。