Mitamura Mizuho, Kase Satoru, Suimon Yuka, Kato Kenjiro, Kanno-Okada Hiromi, Ishida Susumu
Department of Ophthalmology, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, N-15, W-7, Kita-ku, Sapporo, 060-8638, Japan.
Department of Surgical Pathology, Hokkaido University Hospital, Sapporo, Japan.
BMC Ophthalmol. 2024 Dec 27;24(1):549. doi: 10.1186/s12886-024-03825-8.
BACKGROUND/AIM: Mucosa-associated lymphoid tissue (MALT) lymphomas occur in not only the ocular adnexa, but rarely in the sclera or uvea. Histopathological confirmation contributes to a better understanding of the pathogenesis and treatment. We report a case of uveoscleral MALT lymphoma with angle-closure glaucoma.
A 73-year-old man was referred to our hospital for a detailed examination of a choroidal mass oculus sinister (OS). At the initial examination, best-corrected visual acuity (BCVA) was 0.4 OS, intraocular pressure was 37 mmHg OS, the left eye had a narrow angle with anterior chamber inflammation. Optical coherence tomography (OCT) showed marked choroidal elevation. Anterior segment OCT showed tumor invasion into the inferior angle and ultrasound B-mode echography demonstrated choroidal thickening and a banded hypoechoic area posterior to the eye. Magnetic resonance imaging showed isointensity in the tumor on heterogeneous enhancement on gadolinium contrast-T1WI. A tumor biopsy of the left sclera was performed one month after the initial visit. Based on pathological findings, he was diagnosed with uveoscleral MALT lymphoma. Two months after the initial visit, left eye irradiation was performed. Nine months after the initial visit, the tumor was in remission with open angle.
Angle-closure glaucoma caused by the uveoscleral MALT lymphoma was treated with radiotherapy, leading to IOP normalization as well as tumor remission.
背景/目的：黏膜相关淋巴组织（MALT）淋巴瘤不仅可发生于眼附属器，也罕见于巩膜或葡萄膜。组织病理学确诊有助于更好地理解其发病机制及治疗。我们报告1例伴有闭角型青光眼的葡萄膜巩膜MALT淋巴瘤病例。
一名73岁男性因左眼脉络膜肿物被转诊至我院进行详细检查。初诊时，左眼最佳矫正视力（BCVA）为0.4，眼压为37 mmHg，左眼房角狭窄伴前房炎症。光学相干断层扫描（OCT）显示脉络膜明显隆起。眼前节OCT显示肿瘤侵犯下角，超声B型扫描显示脉络膜增厚及眼球后方带状低回声区。磁共振成像显示钆对比剂增强T1加权像（T1WI）上肿瘤呈等信号且不均匀强化。初诊1个月后对左眼巩膜进行肿瘤活检。根据病理结果，诊断为葡萄膜巩膜MALT淋巴瘤。初诊2个月后，对左眼进行放疗。初诊9个月后，肿瘤缓解且房角开放。
葡萄膜巩膜MALT淋巴瘤所致闭角型青光眼经放射治疗后眼压恢复正常，肿瘤缓解。
