Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
BMC Cancer. 2019 Apr 15;19(1):355. doi: 10.1186/s12885-019-5530-7.
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) that often affects men over the age of 60. Systemic metastasis of MCL to eyes is rare and intraocular involvement is even rarer, which usually affects the choroid and iris. To the best of our knowledge, ciliary body metastasis of systemic MCL has not been reported.
A 59-year-old Han Chinese male with past-history of systemic MCL complained of redness, pain and blurred vision in the left eye. Ocular examination revealed a normal appearance in the right eye, and conjunctival injection, pseudohypopyon and anterior protrusion of peripheral iris in the left eye, all of which were unresponsive to corticosteroid treatments. Ultrasound biomicroscopy (UBM) and B-scan were then performed which detected ciliary body masses in both eyes with no vitreous and retino-choroidal anomalies. Combined liquid-based cytology tests and gene rearrangement assays of the aqueous humor specimen confirmed this to be a B-cell malignancy. Then both eyes were treated with external beam irradiation (40 Gy, delivered evenly in twenty fractions) over a course of one month. Additionally, the left eye received intravitreal methotrexate (MTX) (weekly for the first month, every two weeks for the second month, and monthly thereafter) over a course of twelve months. This therapy eventually led to complete remission of all symptoms in one month and disappearance of the ciliary body masses in twelve months.
Here we first reported a case of bilateral ciliary body MCL infiltration which was diagnosed by combined liguid-based cytology and gene rearrangement of aqueous humor cells. UBM may serve as a valuable tool in the diagnosis and serial assessments of anterior segment tumors.
套细胞淋巴瘤（MCL）是一种罕见的侵袭性 B 细胞非霍奇金淋巴瘤（NHL），通常影响 60 岁以上的男性。MCL 向眼部的全身转移较为罕见，眼内受累更罕见，通常影响脉络膜和虹膜。据我们所知，MCL 全身转移至睫状体尚未有报道。
一名 59 岁汉族男性，有系统性 MCL 病史，主诉左眼发红、疼痛和视力模糊。眼部检查发现右眼外观正常，左眼结膜充血、假性前房积脓和周边虹膜前突，所有这些都对皮质类固醇治疗无反应。随后进行了超声生物显微镜（UBM）和 B 型扫描，发现双眼睫状体有肿块，玻璃体和视网膜脉络膜无异常。结合房水标本的液体基细胞学检查和基因重排检测，证实这是一种 B 细胞恶性肿瘤。然后，双眼接受了为期一个月的外照射（40Gy，20 次均匀照射）。此外，左眼在 12 个月内接受了玻璃体内甲氨蝶呤（MTX）（第一个月每周一次，第二个月每两周一次，此后每月一次）。该治疗方案最终在一个月内使所有症状完全缓解，12 个月后睫状体肿块消失。
我们首次报道了一例双侧睫状体 MCL 浸润病例，该病例通过房水细胞的联合液体基细胞学和基因重排检测诊断。UBM 可能是诊断和前节肿瘤系列评估的一种有价值的工具。
