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[MALT-type B-cell lymphoma masquerading as scleritis or posterior uveitis]
D Gaucher1, B Bodaghi, F Charlotte
1Service d'Ophtalmologie, Groupe Hospitalier Pitié-Salpêtrière, 4783 boulevard de l'Hôpital, 756 Paris cedex 13, France.
Journal Francais D'Ophtalmologie
|March 16, 2005
Summary
Ocular MALT lymphoma can mimic various forms of uveitis and scleritis. Early diagnosis through orbital imaging and biopsy, followed by chemotherapy and radiotherapy, can lead to significant visual recovery.
Area of Science:
- Ophthalmology
- Oncology
- Pathology
Background:
- Mucosa-associated lymphoid tissue (MALT) lymphoma can present with ocular manifestations.
- Ocular MALT lymphoma can mimic inflammatory conditions like uveitis and scleritis, leading to diagnostic challenges.
Observation:
- Three patients with severe vision loss resistant to corticoid treatment presented with various forms of posterior uveitis or scleritis.
- Orbital imaging revealed posterior scleral thickening in all cases, prompting further investigation.
- Systemic malignancies were noted in two of the three patients.
Findings:
- Diagnosis of ocular MALT lymphoma was confirmed via scleral biopsy and immunohistochemical analysis (CD20(+), CD5(-)).
- All patients received chemotherapy and radiotherapy, resulting in stabilized lesions, improved visual acuity, or full recovery.
Implications:
- Ocular MALT lymphoma presents with diverse clinical features, often masquerading as inflammatory eye diseases.
- Prompt diagnosis via advanced imaging and pathological analysis is crucial for effective treatment and visual preservation.
- Suspected cases of chronic, corticoid-resistant uveitis warrant specialized radiological evaluation and potentially multiple orbital biopsies.