Intraocular Lymphoma - a Study in 14 Patients with NHL
Říhová E.1, Šišková A.1, Jandusová J.1, Kovařík Z.1, Šach J.2, Adam P.3
1Oční klinika VFN a 1. LF UK, Praha, přednosta doc. MUDr.M. Filipec, CSc. 2Ústav patologie FN KV, Praha, přednosta prof. MUDr. V. Mandys, CSc.3Likvorologická laboratoř OKBHI, Nemocnice na Homolce, Praha, přednosta doc. MUDr. P. Adam, CSc. |
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Summary:
Aim: To evaluate the course of clinical picture of intraocular lymphoma, possibilities
of examination of this disease and the association with general symptoms of
the non-Hodgkin lymphoma (NHL) in patients with manifestations of uveitis.
Patients and Methods: a retrospective study in 14 patients followed in the period
of 1996 - 2001 in the Center for Diagnostics and Therapy of Uveitis, Ocular Clinic
of General Faculty Hospital and 1st Medical Faculty, Charles University in Prague.
Results: The group included 7 women and 7 men at the average age of 57.3 years
(18-82) with clinical picture of uveitis. The time period fromthe first symptoms to
the diagnosis of NHL was 5 – 38 months (mean, 14.6 month). In two patients the
diagnosis of systemic NHL preceded ocular symptoms, in four other patients the
diagnosis of systemic or central nervous system NHL (CNS NHL) was established
during ocular manifestations of uveitis. Intraocular lymphoma was the only first
manifestation of CNS NHL in six patients for the period of 9-34 months (mean, 15.2). Two patients have been so far affected by primary intraocular lymphoma
(PIL) for 8 and 14 months respectively, and presently do not display any signs of
systemic orCNSNHL. Clinical signs of intraocular inflammation of both eyes were
encountered in 71.4 % of patients. Vitritis (85.7 %) and tumor infiltration of retina
(65.3 %) were the most frequent manifestations of NHL. Intraocular NHL was
diagnosed on the basis of cytological examination of samples of intraocular fluids
in 8 patients (57.1 %). In four patients radiotherapy was applied onto 5 eyes and
in 5 patients radiotherapy of CNS was used. Nine patients were treated with
chemotherapy. 50 % of patients died until the end of 2001, the survival from the
establishment of diagnosis was 20.6 months on the average.
Conclusions: intraocular lymphoma should be considered as the eye and life-threatening
disease. Cytological examination of intraocular fluids in patients with
uveitis who do not respond to the therapy with steroids in the usual way may give
more precision and shorten the establishment of diagnosis in this masquerade
syndrome. Early diagnosis and therapy may improve the prognosis of NHL.
Key words:
uveitis, masquerade syndrome, intraocular lymphoma, non-Hodgkin
lymphoma of CNS, systemic NHL, examination procedures,
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