[Optic nerve involvement in chronic lymphatic leukemia of the B-cell series].

BACKGROUND

Malignant Non-Hodgkin lymphomas rarely manifest with ocular symptoms. We report on a patient with a low grade malignant lymphoma of the b-cell type with optic nerve involvement.

PATIENT

In 1990 a 38-year old patient presented with typical symptoms of optic neuritis in the left eye. Magnetic resonance imaging (MRI) revealed a signal enhancement in the left optic nerve. Hematologically a well differentiated Non Hodgkin's lymphoma of the b-cell type was diagnosed. Neurological signs and symptoms in the following years were regarded as manifestations of multiple sclerosis (MS). In 1994 the patient presented with an acute visual loss in the right eye. MRI this time revealed a signal enhancement in the right optic nerve and a big CNS lesion. Gradually a bilateral partial optic nerve atrophy developed. The cerebrospinal fluid contained atypical lymphocytes, matching with the cells in the peripheral blood, morphologically and in the fluorescence-activated cell sorter (FACS). These findings suggest an intracerebral manifestation of a well differentiated Non-Hodgkin's lymphoma.

CONCLUSION

Low grade malignant well-differentiated Non-Hodgkin lymphomas infiltrate the optic nerve. The clinical course in our case mimicked multiple sclerosis.