Ocular Infiltration as the Only Relapse Sign of Atypical Lymphoma Under Chemotherapy: A Case Report

Among the variants of non-Hodgkin's lymphoma (NHL), peripheral T-cell lymphomas (PTCLs) are the least occurring. An aggressive subtype is the extranodal natural killer/T-cell lymphoma (ENKTCL) which commonly affects the nasal cavity. Ocular complications of the disease could arise due to anatomical adjacency yet it is seldom reported. We present the case of a 42-year-old male diagnosed with ENKTCL, nasal type stage IV-B with central nervous system involvement. The patient underwent three cycles of chemotherapy to which there was a complete response until relapse occurred in the form of progressive vision loss and right optic nerve infiltration. A diagnostic vitrectomy was performed, and vitreous fluid flow cytometry revealed the presence of natural killer (NK) cells. Ocular manifestations are rarely reported in the literature, yet this could be crucial to follow up on. A regular ophthalmological examination should be warranted for all cases of ENKTCL with the aim of detecting recurrence and prevention of vision loss.