title: [MALT-type B-cell lymphoma masquerading as scleritis or posterior uveitis].
abstract: OBJECTIVE
  Diagnostic and therapeutic management of masquerade syndromes associated with MALT-type lymphoma.
  
  
  METHODS
  We report the cases of three patients referred for acute or chronic severe loss of visual acuity. All of them suffered from uveitis or scleritis resistant to corticoid treatment. Each one had posterior uveitis associated with retinochoroidal infiltration, anterior scleritis associated with uveal effusion syndrome, or bilateral pan-uveitis associated with serous retinal detachment. Two patients had medical records of systemic malignancies. They underwent an extensive work-up. Search for an infectious, immune or malignant disease was negative but orbital imaging showed a posterior scleral thickening in all cases.
  
  
  RESULTS
  Diagnosis of mucosa-associated lymphoid tissue (MALT) ocular lymphoma was assessed in all cases after scleral biopsy. Immunohistochemical analysis showed CD20(+) and CD5(-) scleral lymphocyte infiltrates. The three patients underwent chemotherapy associated with radiotherapy. Lesions were stabilized in the first case, whereas six lines of visual acuity improvement was noted in the second one, and full recovery was achieved after treatment in the third case.
  
  
  CONCLUSIONS
  Clinical manifestations of this ocular lesion seem to be multiple, masquerading as different types of posterior uveitis or scleritis. In the three cases, we did found other systemic locations of MALT-type lymphoma. Diagnosis was mainly based on pathological analysis. Fast visual recovery in two cases demonstrated the importance of an early diagnosis and a specific treatment. All cases of chronic and corticoid-resistant posterior uveitis require a specialized radiological evaluation followed, if necessary, by multiple orbital biopsies.
authors.affiliation: Service d'Ophtalmologie, Groupe Hospitalier Pitié-Salpêtrière, 4783 boulevard de l'Hôpital, 756 Paris cedex 13, France.
authors.forename: D
authors.initials: D
authors.lastname: Gaucher
authors.forename: B
authors.initials: B
authors.lastname: Bodaghi
authors.forename: F
authors.initials: F
authors.lastname: Charlotte
authors.forename: C
authors.initials: C
authors.lastname: Schneider
authors.forename: N
authors.initials: N
authors.lastname: Cassoux
authors.forename: C
authors.initials: C
authors.lastname: Lemaitre
authors.forename: V
authors.initials: V
authors.lastname: Leblond
authors.forename: N
authors.initials: N
authors.lastname: Rao
authors.forename: P
authors.initials: P
authors.lastname: LeHoang
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D015423:Scleritis / Q000175:diagnosis*; D014605:Uveitis / Q000175:diagnosis*