Isolated lymphoma of the anterior visual pathway diagnosed by optic nerve biopsy.
A 72-year-old previously healthy man developed rapidly progressive visual loss, and brain imaging showed features suggestive of a malignant glioma of the anterior visual pathway. Biopsy of one optic nerve yielded a diagnosis of lymphoma. There was no evidence of an extracranial non-Hodgkin lymphoma, so the conclusion was that this represented a primary central nervous system lymphoma (PCNSL). PCNSL isolated to the optic chiasm has been described only once in an immunocompetent patient. Our patient is unusual in that the lymphoma involved the optic nerve, chiasm, and tract in an immunocompetent patient.
Zelefsky
Joseph R
JR
Department of Ophthalmology, New York University School of Medicine, New York, New York 10016, USA. jzelefsk@yahoo.com
Revercomb
Carolyn H
CH
Lantos
George
G
Warren
Floyd A
FA
D000368:Aged; D000951:Antigens, Neoplasm / Q000032:analysis / Q000276:immunology; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000032:analysis / Q000276:immunology; D001706:Biopsy; D003937:Diagnosis, Differential; D018450:Disease Progression; D017809:Fatal Outcome; D006801:Humans; D002955:Leucovorin / Q000627:therapeutic use; D016393:Lymphoma, B-Cell / Q000175:diagnosis* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D009361:Neoplasm Invasiveness / Q000473:pathology; D009897:Optic Chiasm / Q000473:pathology* / Q000503:physiopathology; D009900:Optic Nerve / Q000473:pathology* / Q000503:physiopathology; D019574:Optic Nerve Neoplasms / Q000175:diagnosis* / Q000503:physiopathology; D011241:Prednisone / Q000627:therapeutic use; D017211:Treatment Failure; D015354:Vision, Low / Q000209:etiology* / Q000473:pathology* / Q000503:physiopathology; D014803:Vitamin B Complex / Q000627:therapeutic use
D000951:Antigens, Neoplasm; D000964:Antimetabolites, Antineoplastic; D018931:Antineoplastic Agents, Hormonal; D014408:Biomarkers, Tumor; D014803:Vitamin B Complex; D002955:Leucovorin; D011241:Prednisone; D008727:Methotrexate