AN INFILTRATIVE CHOROIDAL LESION.

PURPOSE: To present a distinctive case of primary choroidal lymphoma diagnosed by choroidal biopsy with myeloid differentiation primary response 88 testing.

METHODS

We describe the case of a 55-year-old man with unilateral progressive blurry vision. Fundus examination found a whitish/yellowish infiltrative lesion in the posterior pole with macular edema, which had interval improvement with oral prednisone, followed by worsening on optical coherence tomography with persistent subretinal hyper-reflective materials.

RESULTS

Because the initial pars plana vitrectomy/vitreous biopsy and choroidal fine needle aspiration biopsy were inconclusive, the second fine needle aspiration biopsy was performed with an additional myeloid differentiation primary response 88 genetic test that revealed a rare in-frame deletion of myeloid differentiation primary response 88 (p.D288_T294del) in the choroidal sample.

CONCLUSION

The diagnosis of primary choroidal lymphoma was eventually established. After treatment with methotrexate, followed by external beam radiotherapy, the choroidal infiltrate was normalized on B scan.