Ocular involvement in nasal natural killer T-cell lymphoma.
OBJECTIVE
To describe the clinical, morphologic, and immunohistochemical features of a case of paranasal natural killer/T-cell lymphoma (NKTL) with ocular involvement.


METHODS
In March 2005 the patient presented with a maxillary sinusitis and upper nasal obstruction. In July she underwent a nasal computed tomography (CT) scan and multiple biopsies of the granulomatous tissue in the nasal fossae. The diagnosis was NK/T non-Hodgkin's lymphoma nasal type, stage IV A. Afterwards she presented anterior uveitis. In September after the diagnosis of lymphoma the patient underwent a bone marrow biopsy and thoracic and abdominal CT scan. An ophthalmic examination including visual acuity assessment and fundoscopic examination was made. In October she started chemotherapy cycles. Maxillary CT scan and ophthalmic examinations were performed during the cycles. In January 2006 after severe recurrences of panuveitis a diagnostic vitrectomy was performed.


RESULTS
A diagnosis of T-lymphoma cells in the vitreous was made; the tumor was most likely originating from her paranasal NKTL. The condition of the patient deteriorated rapidly and she expired on February 2006.


CONCLUSIONS
Nasal and paranasal sinus lymphomas are rare, but aggressive diseases with a tendency to invade tissues and spread to CNS, including the eye. Ocular manifestations prior to systemic ones may be useful to monitor the response to therapy.
Cimino
Luca
L
Department of Ophthalmology, Arcispedale S.M. Nuova, Viale Risorgimento 80, Reggio Emilia, Italy. l.cimino@libero.it
Chan
Chi-Chao
CC
Shen
DeFen
D
Masini
Luciano
L
Ilariucci
Fiorella
F
Masetti
Maurizio
M
Asioli
Silvia
S
Sartori
Antonio
A
Cappuccini
Luca
L
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005123:Eye / Q000473:pathology*; D017809:Fatal Outcome; D005260:Female; D005654:Fundus Oculi; D006801:Humans; D016399:Lymphoma, T-Cell / Q000151:congenital / Q000188:drug therapy / Q000473:pathology*; D008875:Middle Aged; D055611:Natural Killer T-Cells; D009361:Neoplasm Invasiveness; D010255:Paranasal Sinus Neoplasms / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D011241:Prednisone / Q000627:therapeutic use; D012008:Recurrence; D014605:Uveitis / Q000209:etiology; D014750:Vincristine / Q000627:therapeutic use; D014822:Vitreous Body / Q000473:pathology
D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone