Karishma Habbu1, Roshan George1, Miguel Materin1,2. 1. Department of Ophthalmology, University of North Carolina Kittner Eye Center, Chapel Hill, North Carolina, USA. 2. Department of Ophthalmology, Duke Eye Center, Durham, North Carolina, USA.
Abstract
PURPOSE: This report describes a case of relapsed primary breast lymphoma (PBL) presenting as vitreoretinal lymphoma (VRL). METHODS: We describe the clinical and hematopathologic findings in a patient with relapsed PBL involving the vitreous of both eyes. RESULTS: A 59-year-old woman was treated for PBL with systemic and intrathecal chemotherapy 5 years prior to presentation. Three years later, she presented to an outside clinic with blurred vision in both eyes and bilateral vitritis. She was referred to our clinic with concern for ocular lymphoma. On presentation, the patient's best-corrected visual acuity was 20/40 in the right eye and 20/25 in the left eye with 3+ vitreous cells in the right eye and 2+ vitreous cells in the left eye. Vitreous biopsy of the right eye revealed CD5-negative/CD10-negative B-cell lymphoma cells on flow cytometry. She had no evidence of disease on brain MRI, lumbar puncture, bone marrow biopsy, or full-body CT scans. She was treated with a regimen of rituximab, methotrexate, procarbazine, and vincristine for central nervous system penetration as well as multiple intraocular injections of methotrexate and rituximab with improvement in vision and ocular inflammation bilaterally. CONCLUSION: Relapsed PBL can present as bilateral VRL.
PURPOSE: This report describes a case of relapsed primary breast lymphoma (PBL) presenting as vitreoretinal lymphoma (VRL). METHODS: We describe the clinical and hematopathologic findings in a patient with relapsed PBL involving the vitreous of both eyes. RESULTS: A 59-year-old woman was treated for PBL with systemic and intrathecal chemotherapy 5 years prior to presentation. Three years later, she presented to an outside clinic with blurred vision in both eyes and bilateral vitritis. She was referred to our clinic with concern for ocular lymphoma. On presentation, the patient's best-corrected visual acuity was 20/40 in the right eye and 20/25 in the left eye with 3+ vitreous cells in the right eye and 2+ vitreous cells in the left eye. Vitreous biopsy of the right eye revealed CD5-negative/CD10-negative B-cell lymphoma cells on flow cytometry. She had no evidence of disease on brain MRI, lumbar puncture, bone marrow biopsy, or full-body CT scans. She was treated with a regimen of rituximab, methotrexate, procarbazine, and vincristine for central nervous system penetration as well as multiple intraocular injections of methotrexate and rituximab with improvement in vision and ocular inflammation bilaterally. CONCLUSION: Relapsed PBL can present as bilateral VRL.
Authors: Chi-Chao Chan; James L Rubenstein; Sarah E Coupland; Janet L Davis; J William Harbour; Patrick B Johnston; Nathalie Cassoux; Valerie Touitou; Justine R Smith; Tracy T Batchelor; Jose S Pulido Journal: Oncologist Date: 2011-11-01
Authors: Diva R Salomão; José S Pulido; Patrick B Johnston; Irene Canal-Fontcuberta; Andrew L Feldman Journal: JAMA Ophthalmol Date: 2013-09 Impact factor: 7.389