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CASE REPORT
Diagnostic dilemma of ocular lymphoma
  1. Vasilios Batis,
  2. James Shuttleworth,
  3. Garry Shuttleworth and
  4. Gwyn Samuel Williams
  1. Singleton Hospital, Swansea, UK
  1. Correspondence to Gwyn Samuel Williams, gwynwilliams{at}doctors.org.uk

Abstract

We report a very unusual presentation of primary intraocular lymphoma masquerading as anterior uveitis with atypical symptoms. A 68-year-old man, initially presented with a 4-day history of painless, left blurred vision. Examination revealed 2 or more anterior chamber cells, mutton-fat keratic precipitates and posterior synechiae. Treatment was initiated, the eye settled, and the patient was discharged. He re-presented 7 months later with hypopyon, a hazy cornea, fibrin deposits and a narrowed anterior chamber angle. Over the coming weeks, it became apparent that the temporal iris was thickened, involving the angle, and his intraocular pressure increased despite topical dorzolamide. Following advice from a tertiary centre and referral to a regional ocular oncology centre, a transscleral biopsy was performed and suggested a ciliary body melanoma. Enucleation was advised and performed, with histological examination revealing features consistent with an ocular diffuse large B-cell lymphoma not involving the optic nerve, sclera or cornea. This is the first ever published report of a case of ocular lymphoma masquerading in this way.

  • CNS cancer
  • iris
  • anterior chamber
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Footnotes

  • Contributors VB and JS wrote the first draft of the report. GS provided specialist advice and provided links to other studies of relevance. GSW and GS were the main care providers for the patient, arranged pictures, prepared the report and wrote the final draft for submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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