[Malignant intraocular lymphoma]

A thirty-year-old patient irradiated five years previously on account of a cerebral tumour was admitted for pars plana vitrectomy with the diagnosis of bilateral chronic uveitis and secondary glaucoma. The intraocular inflammation was characterized by corneal precipitates, pseudohypopyon, circulating large cell conglomerates in the anterior chamber and a dense whitish infiltration of the vitreous cavity. Because an intraocular malignant lymphoma was suspected, repeatedly a diagnostic pars plana vitrectomy was performed on the right eye and once on the left eye and bilateral actinotherapy was administered. Only the last cytological examination revealed the presence of lymphoma cells. The course of the disease on the two eyes differed. In the right eye despite repeated actinotherapy and repeated pars plana vitrectomy the disease proceeded by infiltration of the retina and the optic disc. In the left eye after par plana vitrectomy the finding on the ocular fundus was permanently without focal changes. An intraocular malignant lymphoma is usually masked by the picture of chronic uveitis. Careful analysis of the case-history, clinical picture and above all the awareness of this life threatening disease, are decisive for establishment of the correct diagnosis.