Choroidal lymphoma with orbital and optic nerve extension: case and review of literature

Baryla, Julia; Allen, Larry H.; Kwan, Keith; Ong, Michael; Sheidow, Tom G.

doi:10.1016/j.jcjo.2011.12.017

Cited by 21 publications

(6 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition to these three large series, 26 previously reported cases of choroidal extranodal marginal zone lymphoma with adequate and detailed demographic, clinical, and histological data were found 4–19. There were 16 men and 10 women.…”

Section: Discussionmentioning

confidence: 94%

Choroidal extranodal marginal zone lymphoma diagnosed by full-thickness retinochoroidal biopsy: case report and review of the literature

Dirani

Allaire

Callejo

et al. 2017

IMCRJ

View full text Add to dashboard Cite

The case of an 89-year-old man who was referred for a painless decrease of vision in his right eye (RE) is reported. Fundus examination of the RE showed an elevated amelanotic lesion located in the posterior pole with an adjacent focal round pigmented lesion. There was also a more peripheral amelanotic lesion extending from 6 to 9 o’clock clockwise inferotemporally. Uveitis workup and imaging studies of brain and orbits were normal. A retinochoroidal biopsy was done and showed the presence of choroidal extranodal marginal zone lymphoma. The patient was treated with external beam radiotherapy. This report presents a review of the literature of all reported cases of choroidal extranodal marginal zone lymphoma.

show abstract

Section: Discussionmentioning

confidence: 94%

Choroidal extranodal marginal zone lymphoma diagnosed by full-thickness retinochoroidal biopsy: case report and review of the literature

Dirani

Allaire

Callejo

et al. 2017

IMCRJ

View full text Add to dashboard Cite

show abstract

“…1 The most used therapy in these cases is EBRT, and a large amount of reports support it to be the most effective therapy to manage CLs. 1–3,5,6 However, as our patient refused this possibility initially, we decided to use intravitreal rituximab (a chimeric monoclonal antibody that targets the CD20 protein found on the surface of B-cells). It has been reported a good option in systemic lymphomas and also in PVRLs.…”

Section: Discussionmentioning

confidence: 99%

“…4 Involvement of the central nervous system (CNS) is infrequent, and the prognosis tends to be good with external beam radiotherapy (EBRT). 4–6 Primary vitreoretinal lymphoma (PVRL) represents a highly malignant intraocular lymphoma with a poor prognosis in contrast to uveal lymphomas. 4…”

Section: Introductionmentioning

confidence: 99%

Choroidal lymphoma diagnosed by polymerase chain reaction–based clonality assessment

Hernández-Pons

Gómez-Beltrán

Fernández-Zarzoso

et al. 2020

European Journal of Ophthalmology

View full text Add to dashboard Cite

Purpose: To report a case of primary choroidal lymphoma that was confirmed by polymerase chain reaction–based clonality testing. Case report: A 50-year-old woman presented with unilateral progressive vision loss. Fundus examination and B-ultrasonography demonstrated diffuse choroidal thickening without vitritis. Pars plana vitrectomy and subretinal biopsy were performed, and histopathologic analysis revealed choroidal B-cell lymphoid hyperplasia without evidence of neoplasia. Extraocular extension was ruled out, and transitory improvement was observed with oral steroids. After 1-year follow-up, she was referred to our hospital and clonality testing was performed using the samples taken months before. First, we used a forensic DNA extraction kit, and then, a multiplex polymerase chain reaction was carried out using the IgH Rearrangements Molecular Analysis Kit. Clonal rearrangement was identified for the immunoglobulin heavy chain framework regions 1 and 2, and B-cell choroidal lymphoma was confirmed. The patient began treatment with intravitreal rituximab, but no response was observed. Finally, complete regression was achieved using external beam radiotherapy. Conclusion: Polymerase chain reaction–based clonality testing can be a valuable tool to confirm a choroidal lymphoproliferative process.

show abstract

“…Ocular involvement, usually affecting the retina, the vitreous, or the optic nerve head, can be found in about 20% of patients with primary central nervous system lymphoma (PCNSL), whereas optic nerve infiltration (ONI) is a rare condition. Infrequently, choroidal lymphoma can extend to the optic nerve and the orbit …”

Section: Introductionmentioning

confidence: 99%

“…Infrequently, choroidal lymphoma can extend to the optic nerve and the orbit. 2 Sporadic case reports on isolated ONI as the initial manifestation of PCNSL have been published. 3 Another case report 4 describes isolated infiltration of the visual pathways, and anecdotal observations 5 describe contiguous ONI in primary vitreoretinal lymphoma.…”

mentioning

confidence: 99%

Optic Nerve Infiltration in Primary Central Nervous System Lymphoma

et al. 2017

View full text Add to dashboard Cite

IMPORTANCEVisual impairment in primary central nervous system lymphoma (PCNSL) is caused mostly by intraocular lymphomatous involvement (vitritis and retinal infiltration), whereas optic nerve infiltration (ONI) is a rare condition.OBJECTIVE To describe the clinical presentation of ONI, its imaging characteristics, and outcome. DESIGN, SETTING AND PARTICIPANTSA total of 752 patients diagnosed with PCNSL were retrospectively identified from the databases of 3 French hospitals from January 1, 1998, through December 31, 2014. Of these, 7 patients had documented ONI. Exclusion criteria were intraocular involvement, orbital lymphoma, or other systemic lymphoma. Clinical presentation, neuroimaging, biological features, treatment, and outcomes were assessed. MAIN OUTCOMES AND MEASURESTreatment response was evaluated clinically and radiologically on follow-up magnetic resonance imaging (MRI) according to the International PCNSL Collaborative Group response criteria. RESULTSThe 7 patients included 5 women and 2 men. Median age at diagnosis was 65 years (range, 49-78 years). Two patients had initial ONI at diagnosis, and 5 had ONI at relapse. Clinical presentation was marked by rapidly progressive and severe visual impairment for all patients. The MRI findings showed optic nerve enlargement in 3 patients and contrast enhancement of the optic nerve in all patients. Additional CNS lesions were seen in 4 patients. Examination of cerebrospinal fluid samples detected lymphomatous meningitis in 2 patients. Clinical outcome was poor and marked by partial recovery for 2 patients and persistent severe low visual acuity or blindness for 5 patients. Median progression-free survival after optic nerve infiltration was 11 months (95% CI, 9-13 months), and median overall survival was 18 months (95% CI, 9-27 months).CONCLUSIONS AND RELEVANCE Optic nerve infiltration is an atypical and challenging presentation of PCNSL. Its visual and systemic prognosis is particularly poor compared with vitreoretinal lymphomas even in response to chemotherapy. Although intraocular involvement is frequent in PCNSL and clinically marked by slowly progressive visual deterioration, lymphomatous ONI is rare and characterized by rapidly progressive severe visual impairment.

show abstract

Choroidal lymphoma with orbital and optic nerve extension: case and review of literature

Cited by 21 publications

References 5 publications

Choroidal extranodal marginal zone lymphoma diagnosed by full-thickness retinochoroidal biopsy: case report and review of the literature

Choroidal extranodal marginal zone lymphoma diagnosed by full-thickness retinochoroidal biopsy: case report and review of the literature

Choroidal lymphoma diagnosed by polymerase chain reaction–based clonality assessment

Optic Nerve Infiltration in Primary Central Nervous System Lymphoma

Contact Info

Product

Resources

About