Department of Ophthalmology and Visual Sciences, University of Louisville, Louisville, Kentucky.
Retin Cases Brief Rep. 2024 Mar 1;18(2):181-183. doi: 10.1097/ICB.0000000000001362.
To report a case of primary vitreoretinal lymphoma (VRL) presenting as diffuse large b-cell lymphoma 19 years after initial systemic follicular lymphoma.
A case report.
An 81-year-old male patient presented with a 1-month history of floaters and blurry vision in the left eye. He had a history of follicular non-Hodgkin lymphoma treated with systemic chemotherapy in 2002 and prostate cancer treated surgically in 2004. Ophthalmic examination revealed vitritis, retinal whitening, perivascular sheathing, and a vascularized cream-colored retinal mass in the superonasal periphery of the left eye. Diagnostic vitrectomy with retina and vitreous biopsies demonstrated diffuse large b-cell lymphoma. Positron emission tomography/computed tomography confirmed the isolated lesion in the left eye without systemic involvement. Treatment with systemic and intraocular chemotherapy was planned.
To the best of our knowledge, this is the first reported case of primary vitreoretinal lymphoma of diffuse large b-cell lymphoma transformed from follicular lymphoma. Intravitreal and systemic chemotherapy, including rituximab, should be considered in the management of patients with transformed vitreoretinal lymphoma.
报告 19 年前初次全身滤泡性淋巴瘤后出现弥漫性大 B 细胞淋巴瘤的原发性玻璃视网膜淋巴瘤(VRL)病例。
病例报告。
一名 81 岁男性患者左眼出现 1 个月的飞蚊症和视力模糊病史。他曾于 2002 年接受全身化疗治疗滤泡性非霍奇金淋巴瘤,于 2004 年接受前列腺癌手术治疗。眼部检查显示左眼玻璃体炎、视网膜变白、血管周围鞘和血管性奶油色视网膜肿块位于超鼻上象限。诊断性玻璃体切除术联合视网膜和玻璃体活检显示弥漫性大 B 细胞淋巴瘤。正电子发射断层扫描/计算机断层扫描证实左眼孤立性病变,无全身受累。计划采用全身和眼内化疗进行治疗。
据我们所知,这是首例由滤泡性淋巴瘤转化而来的原发性玻璃视网膜弥漫性大 B 细胞淋巴瘤病例。对于转化性玻璃视网膜淋巴瘤患者,应考虑玻璃体内和全身化疗,包括利妥昔单抗。