Título / Title

Secondary intraocular lymphoma in patient with primary renal non-Hodgkin large B-cell lymphoma

Introdução / Purpose

To report a case of intraocular lymphoma secondary to primary renal non-Hodgkin large B-cell lymphoma.

Material e Método / Methods

Case-report of the clinical course, multimodal imaging and diagnosis of one patient, with review of literature

Resultados / Results

A 52-year-old male presented with acute low visual acuity concomitant with renal symptomatology. He was hospitalized due to dialytic acute renal insufficiency and went through ophthalmological examination. During his stay at the hospital was diagnosed with non-Hodgkin large B-cell lymphoma confirmed with renal biopsy.
During examination visual acuity in OR was 20/200 and OS 20/20. Slit lamp exam was unremarkable. Tonometry: 12 mmHg on both eyes at 3pm. Fundus examination images on figures 1 and 2

Discussão e Conclusões / Conclusion

While Hodgkin’s lymphoma rarely causes eye disease, non-Hodgkin lymphoma (NHL) is the most common ocular lymphoma. It most typically presents with a decrease in visual acuity and chronic uveitis. Intraocular lymphoma is rare, and less than 200 cases have been reported. Nonetheless, there has been a significant increase in reported cases over the last 20 years, both in immunocompetent and immunocompromised patients. Lymphomas are mainly categorized between non-Hodgkin lymphoma and Hodgkin lymphoma, and primary and secondary intraocular lymphoma. Primary intraocular lymphoma (PIOL) is a subtype of primary central nervous system lymphoma, and secondary intraocular lymphoma is a metastasis from a previous primary visceral lymphoma. Secondary non-Hodgkin lymphoma’s most predominant sites are the inner ocular structures, arising through the choroidal tissues. Ocular involvement tends to be asymmetrical and most common in ages 60 and older. Retinal hemorrhages and cottonwool spots associated with anemia or thrombocytopenia are a common occurrence in NHL patients, the direct retinal involvement, however, is extremely rare in systemic lymphoma cases.

Palavras Chave

Uveitis, Multimodal Imaging, lymphoma, non-Hodgkin, large B-cell lymphoma, intraocular lymphoma

Area

CLINICAL RETINA