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Large cell lymphoma masquerading as a viral retinitis.
M D de Smet1, R B Nussenblatt, J L Davis
1Laboratory of Immunology, National Eye Institute, Bethesda, Maryland.
International Ophthalmology
|October 1, 1990
Summary
A 37-year-old woman with acute retinal necrosis (ARN) developed worsening vitritis unresponsive to treatment. Diagnostic vitrectomy revealed a large B-cell lymphoma, highlighting a rare cause of ocular inflammation.
Area of Science:
- Ophthalmology
- Oncology
- Pathology
Background:
- Acute retinal necrosis (ARN) is a viral retinitis typically managed with antiviral therapy.
- Ocular inflammation, such as vitritis, can have diverse etiologies, including infectious and neoplastic processes.
Observation:
- A 37-year-old female patient presented with bilateral vitritis.
- The patient had a history of ARN in the left eye, which was refractory to Acyclovir and systemic steroids.
- Progressive vitritis over two months prompted further investigation.
Findings:
- Diagnostic vitrectomy was performed to ascertain the cause of persistent vitritis.
- Histopathological analysis of the vitreous sample identified a large B-cell lymphoma.
- The lymphoma showed a predominance of lambda light chains, aiding in subtyping.
Implications:
- This case underscores the importance of considering neoplastic etiologies in persistent or atypical ocular inflammation, even in the context of prior viral retinitis.
- B-cell lymphoma can present as a primary or secondary ocular manifestation, mimicking infectious or inflammatory conditions.
- Early diagnosis through procedures like vitrectomy is crucial for appropriate management and improved patient outcomes in such rare presentations.