[Uveitis and cerebral lymphoma]

A 57 year-old man developed a left posterior uveitis, without obvious aetiology and unresponsive to antibiotherapy and steroids. Nine months later, a lymphoma of the left parieto-occipital area was discovered. An immunological study detected a peripheral blood T lymphocytes deficiency, a B lymphocytes excess and a monoclonal gammopathy (IgM lambda). The latter abnormality disappeared one month after neurosurgery. Tumor cells were of the B lymphoid type with lambda light chain only. Brain irradiation and chemotherapy first improved neurological signs but right uveitis developed. The patient died 22 months after the first ophthalmological symptoms. The association of primary non Hodgkin brain lymphoma (PNHBL) (reticulum-cell sarcoma) with uveitis has already been described in 51 other cases in the literature. Two possibilities are considered: first, uveitis appears with or follows the neurological signs (NS): the prognosis is the same as that of PNHBL alone; second, uveitis appears before the NS: the prognosis is better and can be improved by brain and ocular irradiation. The immunological abnormalities are discussed. T lymphocytes deficiency and B lymphocytes excess have already been described but a monoclonal gammopathy is a more unusual finding.