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AN UNUSUAL CASE OF PRIMARY VITREORETINAL LYMPHOMA: A TRANSFORMED LYMPHOMA
Melih Ustaoglu1, Rooshil Patel, Wei Wang
1Department of Ophthalmology and Visual Sciences, University of Louisville, Louisville, Kentucky.
Retinal Cases & Brief Reports
|February 2, 2023
Summary
This case report details a rare instance of primary vitreoretinal lymphoma (VRL) in an 81-year-old male, presenting as diffuse large B-cell lymphoma 19 years after initial follicular lymphoma treatment. Management involved chemotherapy, highlighting treatment considerations for transformed VRL.
Area of Science:
- Ophthalmology
- Hematology
- Oncology
Background:
- Primary vitreoretinal lymphoma (VRL) is a rare extranodal non-Hodgkin lymphoma.
- Transformation from indolent lymphoma to aggressive subtypes can occur.
Observation:
- An 81-year-old male presented with decreased vision and floaters in the left eye.
- Ophthalmic examination revealed significant intraocular inflammation and a retinal mass.
- The patient had a history of follicular lymphoma treated 19 years prior.
Findings:
- Biopsies confirmed diffuse large B-cell lymphoma (DLBCL) involving the vitreous and retina.
- Imaging ruled out systemic recurrence or involvement of the prostate cancer.
- The DLBCL was identified as a transformation from the patient's prior follicular lymphoma.
Implications:
- This is the first reported case of primary VRL with DLBCL transformation from follicular lymphoma.
- Treatment strategies should include systemic and intraocular chemotherapy, potentially with rituximab.
- Early diagnosis and multimodal treatment are crucial for managing transformed VRL.
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