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Detection of Toxoplasma gondii DNA in primary intraocular B-cell lymphoma.

Primary intraocular lymphoma, a variant of primary central nervous system lymphoma with ocular involvement, is a large B-cell non-Hodgkin's lymphoma. Some cases of primary intraocular lymphoma have been reported to be associated with microorganisms including Epstein-Barr virus (EBV) and human herpes virus-8 (HHV-8), but not parasites. We analyzed 10 cases of primary intraocular lymphoma using microdissection and PCR. Tumor and normal cells were microdissected from ocular tissue on slides and subjected to PCR for genes from Toxoplasma gondii, EBV, and HHV-8. We detected Toxoplasma gondii, not H…

Intraocular Lymphoma: When to Suspect a Sinister Cause of Ocular Haemorrhage.

UNLABELLED: Intraocular lymphoma (IOL) is a rare and life-threatening condition whose aetiology is unclear. Blurred vision, reduced vision, and floaters are common initial symptoms. Posterior vitreous detachment and haemorrhage rarely occur. The authors present the case of a 79-year-old man who initially presented with a 3-month history of fever, night sweats, significant weight loss, bilateral peri-orbital haematoma, red eyes and retro-orbital headache. Physical examination revealed fever, bilateral peri-orbital haematoma, subconjunctival haemorrhage and palpable cervical lymphadenopathy. CT …

Variations in the presentation of primary intraocular lymphoma: case reports and a review.

Primary intraocular lymphoma is a distinct subset of primary non-Hodgkin's lymphoma of the central nervous system (CNS). Diagnosis can be difficult and is often delayed, as the clinical presentation can mimic a number of other ocular conditions. This report describes four different presentations of intraocular lymphoma and focuses on its modes of clinical presentation. Primary intraocular lymphoma can present with a wide variety of manifestations frequently mimicking diffuse uveitis that is refractory to corticosteroids. Subretinal pigment epithelium tumors may be seen. However, other presenta…

Performance of the Interleukin Score for IntraOcular Lymphoma Diagnosis Score in the Diagnosis of Vitreoretinal Lymphoma in Clinical Practice.

PURPOSE: To evaluate the real-world diagnostic performance of the Interleukin Score for IntraOcular Lymphoma Diagnosis (ISOLD) score-a probabilistic formula based on absolute intraocular interleukin-10 (IL-10) and IL-6 levels-and to compare it with absolute cytokine thresholds and the IL-10/IL-6 ratio for vitreoretinal lymphoma (VRL) diagnosis. Because the comparison group consists predominantly of patients who underwent anterior chamber paracentesis (ACP), this study primarily assesses ISOLD performance on aqueous humor (AH) samples while providing additional data on vitreous specimens. DESI…

Primary Orbital Lymphoma Manifesting as Increased Intraocular Pressure: A Case Report.

BACKGROUND Lymphoma can involve any orbital soft tissue (excluding bone) and may mimic other orbital diseases, often leading to misdiagnosis. Early diagnosis improves both disease management and patient survival. This rare case provides insights into the early diagnosis and treatment of orbital lymphoma. CASE REPORT An 87-year-old Asian man presented with sudden swelling of the left eyelid, vision loss, and severe pain. His intraocular pressure increased, and vision eventually deteriorated to no light perception. Biopsy of the orbital mass revealed small cell malignancy. Immunohistochemistry s

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… Introduction Primary ocular lymphoma, comprising primary intraocular lymphoma and primary orbital lymphoma, is a rare malignancy due to the limited presence of native lymphatic tissue in the orbit [ 1 ]. … Intraocular lymphoma is known to elevate intraocular pressure through multiple mechanisms, including neovascular glaucoma resulting from retinal infiltration, secondary glaucoma caused by central retinal vein occlusion, and secondary angle-closure glaucoma due to direct invasion of the ciliary body [ …

Intraocular Metastasis of Large T-cell Lymphoma Transformed from Mycosis Fungoides.

PURPOSE: To describe a rare case of intraocular lymphoma that metastasized from cutaneous mycosis fungoides and transformed to large cell T cell lymphoma resulting in vitreoretinal pathology. METHODS: Retrospective case report. RESULTS: A 57-year-old male presented with 3 months of blurred vision in the right eye. He reported only a medical history of psoriasis. Examination revealed keratic precipitates and dense vitritis in the right eye. He was taken for a diagnostic vitrectomy. Histopathology showed that atypical lymphoid cells and flow cytometry were consistent with transformed large cel…

Suspected Secondary Intraocular Lymphoma With Choroidal Involvement Following Testicular Diffuse Large B-cell Lymphoma: A Case Report.

Secondary intraocular lymphoma is an uncommon manifestation of systemic lymphoma and may relapse in immune-privileged sites years after apparent remission. We report the case of a 67-year-old man with a history of right testicular diffuse large B-cell lymphoma (DLBCL) treated with orchiectomy and systemic chemotherapy who presented five years later with painless progressive vision loss in the left eye. Examination revealed visual acuity of 20/80, fibrinoid material with hemorrhage in the anterior chamber, and yellow-white choroidal infiltrates extending from the optic disc toward the periphery…

A Natural Course From Primary Intraocular Lymphoma to Brain Lymphoma in Four Years According to Patient's Choice.

Primary intraocular lymphoma or vitreoretinal lymphoma is a rare entity of diffuse large B-cell lymphoma that presents vitreous opacity and retinal and choroidal infiltration. Primary central nervous system lymphoma would occur previously, later, or concurrently with respect to primary intraocular lymphoma. This study reported a 72-year-old patient with a pathological diagnosis of primary intraocular lymphoma who developed central nervous system lymphoma four years later in the course of no treatment. She presented with a four-year history of blurred vision in both eyes after cataract surgerie…

Candy Cane Hypopyon Secondary to Intraocular Mantle Cell Lymphoma: A Case Report.

INTRODUCTION: Bilateral hemorrhagic hypopyon, also known as candy cane hypopyon, is an extremely rare presentation which we report as a unique case in association with intraocular mantle cell lymphoma (MCL). CASE PRESENTATION: A 63-year-old white male presented with a 3-week history of conjunctival injection OS that was unresponsive to erythromycin ointment and topical steroids, in the setting of recently discovered diffuse lymphadenopathy and malaise. On presentation, he was found to have bilateral hemorrhagic hypopyon. Lymph node biopsy was diagnostic of MCL, and subsequent anterior chamber

PRESUMPTIVE RECURRENCE OF INTRAOCULAR LYMPHOMA DESPITE CHIMERIC ANTIGEN RECEPTOR T-CELL THERAPY.

PURPOSE: To present the first reported case of presumptive intraocular recurrence of lymphoma following Chimeric Antigen Receptor (CAR) T-cell therapy despite systemic control by CD19-CAR T cells. METHODS: Observational case report. RESULTS: A 59-year-old man with diffuse, large, B-cell lymphoma subsequently developed secondary central nervous system disease despite chemotherapy. He underwent stem cell transplantation but relapsed again and was scheduled to receive CAR T-cell therapy. He developed vitritis several weeks before treatment, with vitreous biopsy showing non-Hodgkin B-cell lympho

Presumed Intraocular Lymphoma Masquerading as Age-Related Macular Degeneration: A Case Report.

PURPOSE: To describe a case of primary vitreoretinal lymphoma (PVRL) that initially presented and managed as dry type age-related macular degeneration (AMD). METHODS: A 69-year-old male was referred to us by decreased vision. RESULTS: On funduscopy, a few small hard drusen at the posterior pole of the right eye and many large confluent drusen in the left eye were observed. Optical coherence tomography findings included the hyperreflective drusenoid materials in the subretinal pigment epithelium (sub- RPE) space which was similar to previous imaging records except for decreased area and heigh

Outcomes of intravitreal methotrexate to salvage eyes with relapsed primary intraocular lymphoma.

PURPOSE: To report the outcomes of intravitreal methotrexate (MTX) injections to rescue eyes with relapsed primary intraocular lymphoma (PIOL). METHODS: Retrospective case series of patients with ocular relapse of PIOL who had initially received systemic chemotherapy (all five cases) and external beam radiotherapy (EBRT) to brain and orbits (two cases). Injections of MTX (400 µg/0.1 mL) were given one time per week for 1 month, every other week for 4 months, followed by a maintenance phase of one injection one time per month for 8 months (total of 20 injections in a year). RESULTS: From Apri…

Anterior chamber paracentesis cytology (cytospin technique) for the diagnosis of intraocular lymphoma.

AIM: To report on the diagnosis of intraocular lymphoma by aqueous cytology. METHODS: Four patients suspected of having intraocular lymphoma were evaluated by anterior chamber (AC) paracentesis with cytology (cytospin technique). All had a history of non-ocular lymphoma and presented with at least one plus anterior chamber cells despite intensive glucocorticoid therapy. A 25 gauge needle was inserted through clear cornea (bevel up), over the iris stroma, so as to drain the AC. The aqueous humour was sent for cytopathology (cytospin technique), culture, and sensitivity tests. RESULTS: All pro…

Intraocular methotrexate in ocular diseases other than primary central nervous system lymphoma.

PURPOSE: To investigate whether intravitreal methotrexate could be safely administered and improve vision in patients with ocular disease other than primary central nervous system lymphoma (PCNSL). DESIGN: A retrospective, small-case series. METHODS: Patients with various clinical conditions were treated with intravitreal methotrexate (cumulative dose < or =400 microg). Visual acuity and clinical examination were recorded to assess the safety and efficacy of the injection. RESULTS: Of 16 study eyes, final visual acuity was improved in seven, remained stable in five, and decreased in four. T

Bilateral intraocular and lung involvements associated with Nasal NK/T-cell lymphoma.

BACKGROUND: To report a rare case of nasal natural killer/T (NK/T) cell lymphoma with bilateral intraocular and lung metastasis and to further describe the clinical features of intraocular manifestations. CASE PRESENTATION: A 54-year-old man presented with a 3-month history of left nasal congestion, and bilateral vision impairment of one week duration. Subsequent maxillary computed tomography (CT) and multiple biopsies confirmed the diagnosis of nasal NK/T-cell lymphoma. EBV-encoded small RNA (EBER) in situ hybridization revealed EBV infection. A comprehensive ophthalmic examination found lym

Intraocular involvement of Mantle cell lymphoma: A case report and literature review.

Lymphomatous involvement of the ocular adnexal region (OAR) is generally rare; however, it constitutes the most common ocular malignancy. Most cases of ocular adnexal lymphomas are extra nodal marginal zone B cell lymphomas. Mantle cell lymphoma involvement (MCL) of the OAR is a less common presentation compared with other lymphomas and it has been reported anecdotally. Studies have suggested an association of OAR involvement with poor prognosis. Here, we report the case of a 61 year old man who started experiencing conjunctival erythema which was followed by development of bilateral proptosis

Use of rituximab for periocular and intraocular mucosa-associated lymphoid tissue lymphoma.

The clinical efficacy of rituximab therapy in systemic mucosa-associated lymphoid tissue (MALT) lymphoma with both periocular and intraocular involvement is described. Ophthalmic examination and radiologic imaging demonstrated tumor with bilateral periorbital, lacrimal, and subconjunctival infiltration, a pseudohypopyon in one eye, and extensive systemic lymph node involvement. Lymph node biopsy confirmed the pathologic findings of a low-grade MALT lymphoma. The patient had a complete remission within 3 months of starting rituximab therapy. A recurrence 6 months later remitted with a second ro

Asymptomatic conjunctival mucosa-associated lymphoid tissue-type lymphoma with presumed intraocular involvement.

PURPOSE: To report a case of conjunctival mucosa-associated lymphoid tissue (MALT) lymphoma with presumed intraocular involvement. METHODS: Observational case report. RESULTS: A 73-year-old white man presented for a routine eye examination and was found to have a salmon-colored bulbar conjunctival mass of the left eye. Ultrasound showed a low-reflective mass with diffuse thickening of the ciliary body and choroid. Immunohistochemistry and flow cytometry of an incisional biopsy specimen suggested a polyclonal lesion. Treatment with topical steroids yielded no clinical improvement, and excisio

Intraocular lymphoma: a series of 14 patients with clinicopathological features and treatment outcomes.

AIMS: To assess the clinical features, pathology, mortality (systemic outcome) and ocular complications (visual outcome) of a cohort of patients treated for intraocular lymphoma. METHODS: Retrospective case analysis of medical records and review of pathology of a consecutive series of patients presenting with intraocular lymphoma in Melbourne over 11 years between 1990 and 2000. Categorical factors influencing survival were examined by the Kaplan-Meier estimator and groups compared with the log rank test. RESULTS: A total of 14 patients were included. The median age of onset of symptoms was …