Dunker S, Reuter U, Rösler A, Wiegand W
Medizinisches Zentrum für Augenheilkunde, Philipps-Universität Marburg.
Ophthalmologe. 1996 Aug;93(4):351-3.
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.
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.
Low grade malignant well-differentiated Non-Hodgkin lymphomas infiltrate the optic nerve. The clinical course in our case mimicked multiple sclerosis.
恶性非霍奇金淋巴瘤很少表现出眼部症状。我们报告一例患有b细胞型低度恶性淋巴瘤且累及视神经的患者。
1990年，一名38岁患者出现左眼视神经炎的典型症状。磁共振成像（MRI）显示左侧视神经信号增强。血液学检查诊断为b细胞型高分化非霍奇金淋巴瘤。在接下来的几年里，神经体征和症状被认为是多发性硬化症（MS）的表现。1994年，患者右眼出现急性视力丧失。此次MRI显示右侧视神经信号增强以及一个大的中枢神经系统病变。逐渐出现双侧部分视神经萎缩。脑脊液中含有非典型淋巴细胞，在形态学上以及荧光激活细胞分选仪（FACS）检测中与外周血中的细胞相匹配。这些发现提示为高分化非霍奇金淋巴瘤的脑内表现。
低度恶性高分化非霍奇金淋巴瘤可浸润视神经。我们病例的临床病程类似多发性硬化症。
