Stéphanie Baillif1, Pierre-Loïc Cornut, Charlotte Girard, Hervé Ghesquieres, Laurent Perard. 1. From the *Department of Ophthalmology, Saint Roch Hospital, Nice, France; Departments of †Ophthalmology, and ‡Internal Medicine, Edouard Herriot Hospital, Lyon, France; and §Department of Medical Oncology, Leon Berard Center, Lyon, France.
Abstract
PURPOSE: To report atypical ocular manifestations in two patients with undiagnosed Hodgkin lymphoma. METHODS: Observational case report. RESULTS: The first patient, a 27-year-old man, presented with bilateral acute angle-closure glaucoma secondary to uveal effusion. Histopathology of chest lymph nodes obtained by mediastinoscopy revealed nodular sclerosing Hodgkin lymphoma. Ocular signs resolved after systemic chemotherapy. The second patient, a 56-year-old man, presented with bilateral multifocal choroiditis. Extensive biologic and microbiologic examinations were negative. Pathologic lymph nodes were detected in the anterior mediastinum. The histopathologic examination of the nodes after mediastinoscopy revealed nodular sclerosing Hodgkin lymphoma. Systemic chemotherapy was instituted. The patient encountered a major increase in the multifocal choroiditis within 3 days after the second chemotherapy injection. High-dose intravenous corticosteroid therapy was initiated. No recurrence of choroidal lesions was observed after the treatment completion. CONCLUSION: These two patients presented with bilateral paraneoplastic uveal tract involvement as initial presentation of Hodgkin lymphoma. Systemic corticosteroid therapy may be associated with systemic chemotherapy to obtain complete remission of the ocular inflammatory activity.
PURPOSE: To report atypical ocular manifestations in two patients with undiagnosed Hodgkin lymphoma. METHODS: Observational case report. RESULTS: The first patient, a 27-year-old man, presented with bilateral acute angle-closure glaucoma secondary to uveal effusion. Histopathology of chest lymph nodes obtained by mediastinoscopy revealed nodular sclerosing Hodgkin lymphoma. Ocular signs resolved after systemic chemotherapy. The second patient, a 56-year-old man, presented with bilateral multifocal choroiditis. Extensive biologic and microbiologic examinations were negative. Pathologic lymph nodes were detected in the anterior mediastinum. The histopathologic examination of the nodes after mediastinoscopy revealed nodular sclerosing Hodgkin lymphoma. Systemic chemotherapy was instituted. The patient encountered a major increase in the multifocal choroiditis within 3 days after the second chemotherapy injection. High-dose intravenous corticosteroid therapy was initiated. No recurrence of choroidal lesions was observed after the treatment completion. CONCLUSION: These two patients presented with bilateral paraneoplastic uveal tract involvement as initial presentation of Hodgkin lymphoma. Systemic corticosteroid therapy may be associated with systemic chemotherapy to obtain complete remission of the ocular inflammatory activity.
Authors: Christopher T Leffler; Stephen G Schwartz; Francesca M Giliberti; Matthew T Young; Dennis Bermudez Journal: Ophthalmol Eye Dis Date: 2015-10-08