Moussa Kareem, Begaj Tedi, Ma Kevin, Barrantes Paula Cortes, Eliott Dean, Sobrin Lucia
Department of Ophthalmology & Vision Science, University of California, Davis, 4860 Y Street, Suite 2400, Sacramento, CA, 95817, USA.
Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA, 02114, USA.
Am J Ophthalmol Case Rep. 2022 Jun 28;27:101643. doi: 10.1016/j.ajoc.2022.101643. eCollection 2022 Sep.
To report a case of systemic diffuse large B cell lymphoma presenting with ocular manifestations and neurologic findings resembling Vogt-Koyanagi-Harada syndrome.
A 51-year-old Caucasian man presented with headache, ear pain, and blurry vision in both eyes. He was found to have bilateral exudative retinal detachments. After a short period of initial improvement with high dose systemic corticosteroid, his condition significantly worsened. An extensive work-up, including a kidney biopsy, led to a diagnosis of systemic diffuse large B cell lymphoma. He had excellent recovery following treatment with appropriate chemotherapy.
Systemic malignancy may present with ocular manifestations and may masquerade as another diagnosis. An unexpected clinical course may suggest an alternative diagnosis. A broad systemic work-up including an evaluation for malignancy should be considered for patients presenting with unexplained exam or systemic findings.
报告一例表现为眼部症状及类似Vogt-小柳-原田综合征神经学表现的系统性弥漫性大B细胞淋巴瘤病例。
一名51岁的白人男性出现头痛、耳痛及双眼视力模糊。检查发现其双眼存在渗出性视网膜脱离。在高剂量全身使用糖皮质激素后短期内病情初步改善，但随后病情显著恶化。经过包括肾脏活检在内的全面检查，最终诊断为系统性弥漫性大B细胞淋巴瘤。经适当化疗后，他恢复良好。
系统性恶性肿瘤可能表现为眼部症状，且可能伪装成其他疾病。意想不到的临床病程可能提示另一种诊断。对于出现无法解释的检查结果或全身症状的患者，应考虑进行包括恶性肿瘤评估在内的全面系统检查。
