Peripheral T-cell lymphoma presenting as sclerouveitis.

Area of Science:

• Ophthalmology
• Oncology
• Immunology

Background:

• Sclerouveitis is an inflammatory eye condition often mimicking infectious or autoimmune diseases.
• Peripheral T-cell lymphoma (PTCL) is a diverse group of aggressive non-Hodgkin lymphomas.

Observation:

• A 53-year-old woman presented with unilateral sclerouveitis unresponsive to antiviral and corticosteroid treatment.
• Conjunctival biopsy revealed intermediate to large lymphocytes with T-cell markers and clonal T-cell receptor gamma gene rearrangements.

Findings:

• The ocular findings were consistent with peripheral T-cell lymphoma.
• An identical T-cell receptor gamma rearrangement was found in an oropharyngeal mucosal lesion, indicating systemic involvement.
• Literature review identified other cases of conjunctival T-cell lymphoma involving upper airway structures and lymphomas mimicking scleritis.

Implications:

• Peripheral T-cell lymphoma should be considered in the differential diagnosis of refractory sclerouveitis.
• Prompt systemic evaluation, including assessment of the upper airway, is warranted upon diagnosis of conjunctival T-cell lymphoma.