Casey Eye Institute, Oregon Health & Science University, Portland, OR.
Department of Pathology, Oregon Health & Science University, Portland, OR.
Retin Cases Brief Rep. 2023 Mar 1;17(2):117-119. doi: 10.1097/ICB.0000000000001172.
To describe a patient with a history of pre-B-cell acute lymphoblastic leukemia in remission, who developed recurrent alternating intraocular leukemia manifesting with pseudohypopyon, uveal mass, and serous retinal detachment. In multiple instances, this constellation of ocular findings preceded systemic leukemia recurrence.
Case report.
A 29-year-old man with a history of pre-B-cell acute lymphoblastic leukemia, in remission after a hematopoietic stem cell transplant, presented with pseudohypopyon, uveal lesions, and serous retinal detachment of the right eye. Comprehensive workup for infectious and inflammatory etiologies was unremarkable, and a bone marrow biopsy revealed systemic recurrence of leukemia. One year later, while again in remission, the patient developed a pseudohypopyon, uveal mass, and serous retinal detachment of the other eye. Repeat bone marrow biopsy showed impending leukemia relapse, which occurred 1 month later. Orbital radiation resulted in complete ocular resolution.
The constellation of pseudohypopyon, serous retinal detachment, and uveal mass (pseudopanuveitis) should be recognized as a harbinger for systemic pre-B ALL recurrence.
描述一位缓解期前 B 细胞急性淋巴细胞白血病病史的患者，其发生复发性交替性眼内白血病，表现为假性前房积脓、葡萄膜肿块和浆液性视网膜脱离。在多个病例中，这种眼部表现先于全身白血病复发。
病例报告。
一名 29 岁男性，有前 B 细胞急性淋巴细胞白血病病史，造血干细胞移植后缓解，出现右眼假性前房积脓、葡萄膜病变和浆液性视网膜脱离。对感染和炎症病因进行了全面检查，但无明显异常，骨髓活检显示白血病全身性复发。一年后，患者再次缓解时，另一只眼出现假性前房积脓、葡萄膜肿块和浆液性视网膜脱离。重复骨髓活检显示即将发生白血病复发，1 个月后复发。眼眶放疗导致眼部完全缓解。
假性前房积脓、浆液性视网膜脱离和葡萄膜肿块（假性全葡萄膜炎）的组合应被视为全身前 B 细胞 ALL 复发的先兆。
