Theophanous Christos, Pekmezci Melike, Damato Bertil E, Kao Andrew A, Bloomer Michele M, Stewart Jay M, Afshar Armin R
Department of Ophthalmology, University of California, San Francisco, California, USA.
Department of Pathology, University of California, San Francisco, California, USA.
Ocul Oncol Pathol. 2018 Sep;4(5):318-321. doi: 10.1159/000486039. Epub 2018 Feb 14.
BACKGROUND/AIMS: To report the case of a 77-year-old male with a blind, painful eye, referred for suspected corneal mass, with finding of choroidal B-cell lymphoma on pathology of enucleated globe.
This is a retrospective case report of a single patient.
A 77-year-old male with a longstanding history of poor vision in the left eye was referred for a scarred, vascularized corneal mass. The patient had reported occasional mild ocular discomfort in the left eye and loss of light perception over the last year. Visual acuity was 20/20 in the right eye and no light perception in the left eye. Intraocular pressure was 32 mm Hg in the left eye. Fundoscopic visualization was not possible due to corneal opacity. B-scan ultrasound showed an infiltrative, low-reflective choroidal lesion and inferior retinal detachment. Pathology from the enucleated globe revealed diffuse sheets of CD20+ small B cells replacing the choroid, characteristic of a low-grade small B-cell extranodal marginal zone lymphoma.
This is an unusual presentation of choroidal lymphoma in an eye with severe corneal opacification and scarring, and underscores the diagnostic value of ultrasonography in examination of eyes without view to the posterior segment.
背景/目的：报告一名77岁男性患者，因疑似角膜肿物就诊，其患眼失明且疼痛，眼球摘除术后病理检查发现脉络膜B细胞淋巴瘤。
这是一份针对单一患者的回顾性病例报告。
一名77岁男性，左眼视力长期不佳，因角膜瘢痕化、血管化肿物前来就诊。患者自述左眼偶尔有轻度眼部不适，且在过去一年中已无光感。右眼视力为20/20，左眼无光感。左眼眼压为32 mmHg。由于角膜混浊，无法进行眼底镜检查。B超显示脉络膜有浸润性、低反射性病变及视网膜下脱离。眼球摘除术后的病理检查显示，弥漫性CD20 +小B细胞片层取代脉络膜，这是低度小B细胞结外边缘区淋巴瘤的特征。
这是脉络膜淋巴瘤在严重角膜混浊和瘢痕化眼中的一种不寻常表现，强调了超声检查在无法观察到眼后段的眼部检查中的诊断价值。
