title: Primary intraocular central nervous system lymphoma masquerading as diffuse retinal vasculitis.
abstract: A 49-year-old woman had blurred vision and floaters of 4 days duration in the right eye. Ocular examination revealed granulomatous panuveitis, vitritis and diffuse retinal vasculitis. Following a strongly positive tuberculin skin test, she received antitubercular therapy with oral steroids and immunosuppressants. A year later, despite therapy, vitritis and vasculitis persisted. Additionally, yellowish white lesions appeared beneath the retinal pigment epithelium. Fluorescein angiography revealed a leopard skin appearance. Following a negative vitreous biopsy, she was subjected to a chorioretinal biopsy which revealed non-Hodgkin's lymphoma. MRI was normal. The ocular lesions resolved following intravitreal methotrexate injections. MRI of the brain was repeated every 3 months to rule out central nervous system (CNS) involvement. About 2.5 years after initial presentation, she complained of ataxia, hypersomnia and speech difficulty. MRI of the brain now showed lesions in the thalamocapsular region and the corpus callosum splenium suggestive of CNS lymphoma. She underwent a whole brain radiation with symptomatic improvement followed by chemotherapy.
authors: Department of Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors: Deeksha
authors: D
authors: Katoch
authors: Reema
authors: R
authors: Bansal
authors: Raje
authors: R
authors: Nijhawan
authors: Amod
authors: A
authors: Gupta
mesh_terms: D000792:Angiography; D016543:Central Nervous System Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000532:radiotherapy; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D005134:Eye Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000532:radiotherapy; D005260:Female; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis* / Q000188:drug therapy / Q000532:radiotherapy; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D031300:Retinal Vasculitis / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery
references: Ophthalmology. 1999 Sep;106(9):1805-10
references: 10485554
references: Nippon Ganka Gakkai Zasshi. 1998 May;102(5):348-54
references: 9619028
references: Ocul Immunol Inflamm. 2000 Dec;8(4):243-50
references: 11262654
references: J Neurosurg. 2000 Feb;92(2):261-6
references: 10659013
references: Nippon Ganka Gakkai Zasshi. 2011 Oct;115(10):910-5
references: 22117324
references: Oncologist. 2011;16(11):1589-99
references: 22045784
references: Int Ophthalmol. 2007 Aug;27(4):241-50
references: 17440686
references: Ophthalmology. 1993 Sep;100(9):1399-406
references: 8371930
references: Ocul Immunol Inflamm. 2009 May-Jun;17(3):133-41
references: 19585354
references: Oncol Lett. 2012 Jun;3(6):1245-1248
references: 22783426
references: Surv Ophthalmol. 2001 May-Jun;45(6):463-71
references: 11425352
references: Br J Ophthalmol. 2008 Mar;92(3):383-8
references: 18303160
references: Eye (Lond). 2007 Jun;21(6):880-1
references: 17304253
references: Ophthalmology. 2009 Apr;116(4):797-801
references: 19344827
references: Surv Ophthalmol. 1994 Sep-Oct;39(2):133-40
references: 7801221