Intraocular Lymphoma: When to Suspect a Sinister Cause of Ocular Haemorrhage
  • Catarina Pestana Santos
    Internal Medicine Department, Hospital Garcia de Orta, Almada, Lisbon, Portugal
  • Rosa Alves
    Internal Medicine Department, Hospital Garcia de Orta, Almada, Lisbon, Portugal
  • Bruno Sousa
    Internal Medicine Department, Hospital Garcia de Orta, Almada, Lisbon, Portugal
  • Ana Cláudia Vieira
    Pneumology Department, Hospital Garcia de Orta, Almada, Lisbon, Portugal
  • Tiago Judas
    Internal Medicine Department, Hospital Garcia de Orta, Almada, Lisbon, Portugal

Keywords

Intraocular lymphoma, ocular haemorrhage, Adrenal mass

Abstract

Intraocular lymphoma (IOL) is a rare and life-threatening condition whose aetiology is unclear. Blurred vision, reduced vision, and floaters are common initial symptoms. Posterior vitreous detachment and haemorrhage rarely occur.

The authors present the case of a 79-year-old man who initially presented with a 3-month history of fever, night sweats, significant weight loss, bilateral peri-orbital haematoma, red eyes and retro-orbital headache. Physical examination revealed fever, bilateral peri-orbital haematoma, subconjunctival haemorrhage and palpable cervical lymphadenopathy. CT scans detected conical intra-orbital lesions, cervical adenomegalies, expansive lesions in the adrenal glands, and thrombosis of the splenomesenteric confluent and posterior segment of the right branch of the portal vein. These findings were suggestive of a lymphoproliferative disorder. Aspiration cytology of the adrenal mass and inguinal adenopathies was compatible with diffuse large B-cell lymphoma with areas of transformation to Burkitt’s lymphoma.

We describe a rare form of lymphoma, and a very unusual presentation of primary intraocular lymphoma with atypical symptoms.

VIEW THE ENTIRE ARTICLE

References

  • Chaput F, Amer R, Baglivo E, Touitou V, Kozyreff A, Bron, D, et al. Intraocular T-cell lymphoma: clinical presentation, diagnosis, treatment, and outcome. Ocul Immunol Inflamm 2017;25(5):644–653.
  • Karakawa A, Taoka K, Kaburaki T, Tanaka R, Shinozaki-Ushiku A, Hayashi H, et al. Clinical features and outcomes of secondary intraocular lymphoma. Br J Haematol 2018;183(4):668–671.
  • Touhami S, Audo I, Terrada C, Gaudric A, LeHoang P, Touitou V, et al. Neoplasia and intraocular inflammation: from masquerade syndromes to immunotherapy-induced uveitis. Prog Retin Eye Res 2019;72:100761.
  • Batis V, Shuttleworth J, Shuttleworth G, Williams GS. Diagnostic dilemma of ocular lymphoma. BMJ Case Reports 2019;12(6):e229513.
  • Sagoo MS, Mehta H, Swampillai AJ, Cohen VM, Amin SZ, Plowman PN, et al. Primary intraocular lymphoma.Surv Ophthalmol 2014;59(5):503–516.
  • Reichstein D. Primary vitreoretinal lymphoma: an update on pathogenesis, diagnosis and treatment. Current Opin Ophthalmol 2016;27(3):177–184.
  • Araujo I, Coupland SE. Primary vitreoretinal lymphoma—a review. Asia Pac J Ophthalmol 2017;6(3):283–289.
  • Berenbom A, Davila RM, Lin HS, Harbour JW. Treatment outcomes for primary intraocular lymphoma: implications for external beam radiotherapy. Eye 2007;21(9):1198–1201.
  • Buettner H, Bolling JP. Intravitreal large-cell lymphoma. Mayo Clin Proc 1993;68(10):1011–1015.
  • Dunn JP. Interleukins in the diagnosis of intraocular lymphoma: do we still need histologic confirmation? Retina 2018;38(4):647–649.
  • Freedman K, Shenoy S. Mucosa-associated lymphoid tissue lymphoma with intraocular and orbital involvement: case presentation and review of the literature. Orbit 2018;37(4):243–247.
  • Views: 334
    HTML downloads: 55
    PDF downloads: 250


    Published: 2022-12-28
    Issue: 2022: Vol 9 No 12 (view)


    How to cite:
    1.
    Pestana Santos C, Alves R, Sousa B, Vieira AC, Judas T. Intraocular Lymphoma: When to Suspect a Sinister Cause of Ocular Haemorrhage. EJCRIM 2022;9 doi:10.12890/2022_003622.