Ocular involvement in neurolymphomatosis.

Area of Science:

• Neurology
• Ophthalmology
• Oncology

Background:

• Neurolymphomatosis (NL) is a rare condition involving lymphoma infiltration of nerves.
• Ocular involvement in NL can present with complex neurological and ophthalmological symptoms.

Observation:

• A man in his 60s with chronic inflammatory demyelinating polyneuropathy developed cranial nerve palsies, ptosis, and ophthalmoplegia.
• Autopsy revealed primary NL with diffuse large B-cell lymphoma affecting cranial nerves V, VI, IX, X, spinal nerve roots, femoral nerves, and ocular nerves.

Findings:

• Histopathology confirmed primary NL with lymphoma extending from ciliary nerves into the choroid of both eyes.
• This is the second reported case of ciliary nerve involvement by NL and the first demonstrating secondary spread into the choroid.

Implications:

• Primary NL should be considered in the differential diagnosis of unexplained ocular cranial nerve palsies and ophthalmoplegia.
• This case expands the understanding of NL's ophthalmic manifestations and its potential intraocular spread.