Choroidal lymphoma: clinical features and association with systemic lymphoma

Area of Science:

• Ophthalmology
• Hematology
• Oncology

Background:

• Choroidal lymphoma (CL) is a rare malignancy affecting the eye.
• Understanding its clinical and histopathologic features is crucial for diagnosis and management.
• Association with systemic lymphoma impacts prognosis and treatment strategies.

Purpose of the Study:

• To detail the clinical and histopathologic characteristics of choroidal lymphoma.
• To investigate the association between choroidal lymphoma and systemic lymphoma.
• To differentiate between primary and secondary choroidal lymphoma.

Main Methods:

• Retrospective observational case series.
• Analysis of 59 patients (73 eyes) diagnosed with choroidal lymphoma.
• Review of clinical features, histopathology, and systemic lymphoma status.

Main Results:

• Systemic lymphoma was absent in 69% (primary CL) and present in 31% (secondary CL) of patients.
• Secondary CL exhibited more aggressive features, including higher rates of poor vision, bilateral involvement, and specific ocular manifestations.
• Secondary CL was morphologically higher grade (e.g., diffuse large cell lymphoma) compared to primary CL.

Conclusions:

• Secondary choroidal lymphoma is morphologically high-grade and presents with more severe ocular findings.
• Systemic evaluation is recommended for patients with CL without a known history of systemic lymphoma.
• Primary CL in this cohort did not show late development of systemic lymphoma.