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Epstein-Barr virus-positive iris diffuse large B-cell lymphoma detected by metagenomic next-generation sequencing
Xiao-Na Wang1, Jing Hong1, Yong-Gen Xu1
1Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damage Ocular Nerve, Peking University Third Hospital, 100191, Beijing, China.
BMC Ophthalmology
|March 4, 2024
Summary
This study reports a rare case of Epstein-Barr virus (EBV)-positive diffuse large B-cell lymphoma (DLBCL) in the iris following penetrating keratoplasty. Treatment led to the disappearance of ocular lesions, suggesting key roles for EBV infection and immune factors.
Area of Science:
- Ophthalmology
- Oncology
- Virology
Background:
- Epstein-Barr virus (EBV)-positive diffuse large B-cell lymphoma (DLBCL) is a rare subtype of DLBCL.
- Iris DLBCL is an uncommon presentation of extranodal lymphoma.
Observation:
- A 72-year-old male presented with blurred vision and observed white nodular lesions on the iris and retina, with vitreous opacity.
- The patient had a history of penetrating keratoplasty.
Findings:
- Pathological and metagenomic tests confirmed EBV-positive iris DLBCL.
- Treatment with intravitreal methotrexate and antiviral therapy resolved ocular lesions.
Implications:
- EBV infection, immunosuppression (potentially from prior surgery/medications), and age-related immune decline may contribute to EBV-positive iris DLBCL.
- This case highlights the importance of considering EBV-positive DLBCL in ocular presentations post-transplant or in elderly patients.
