Primary intraocular lymphoma with a low interleukin 10 to interleukin 6 ratio and heterogeneous IgH gene rearrangement.
Primary intraocular lymphoma is almost always a central nervous system B-cell non-Hodgkin lymphoma. Primary intraocular lymphoma is commonly diagnosed by demonstrating lymphoma cells in the vitreous or cerebrospinal fluid. An interleukin (IL) 10 to IL-6 ratio greater than 1.0 in these fluids and the detection of immunoglobulin gene rearrangement are useful adjuncts in the diagnosis of primary intraocular lymphoma. We report a case of primary intraocular lymphoma diagnosed by chorioretinal biopsy in which no malignant cells were identified in the vitreous and in which the IL-10 to IL-6 ratio was less than 1.0. The detection of IgH gene rearrangement heterogeneity in the tumor cells by polymerase chain reaction, a high tumor mitotic figure rate, and the rapid onset of multiple brain lesions suggest an aggressive malignant neoplasm.
Buggage
R R
RR
Laboratory of Immunology and the Clinical Branch, National Eye Institute, National Institutes of Health, Bethesda, MD 20892-1857, USA. buggager@intra.nei.nih.gov
Velez
G
G
Myers-Powell
B
B
Shen
D
D
Whitcup
S M
SM
Chan
C C
CC
D000328:Adult; D001932:Brain Neoplasms / Q000175:diagnosis; D004273:DNA, Neoplasm / Q000032:analysis; D015326:Gene Rearrangement, B-Lymphocyte, Heavy Chain / Q000235:genetics*; D019254:Genes, bcl-2 / Q000235:genetics; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000235:genetics*; D007133:Immunoglobulin Joining Region / Q000235:genetics; D007135:Immunoglobulin Variable Region / Q000235:genetics; D016753:Interleukin-10 / Q000378:metabolism*; D015850:Interleukin-6 / Q000378:metabolism*; D016393:Lymphoma, B-Cell / Q000175:diagnosis* / Q000235:genetics / Q000378:metabolism; D008279:Magnetic Resonance Imaging; D008297:Male; D016133:Polymerase Chain Reaction; D019572:Retinal Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000378:metabolism; D014178:Translocation, Genetic; D014822:Vitreous Body / Q000378:metabolism / Q000473:pathology
D004273:DNA, Neoplasm; D007143:Immunoglobulin Heavy Chains; D007133:Immunoglobulin Joining Region; D007135:Immunoglobulin Variable Region; D015850:Interleukin-6; D016753:Interleukin-10