Correspondence

Mudhar, Hardeep Singh; Sethuraman, Chitra; Khan, M D; Jan, S U

doi:10.1111/j.1365-2559.2007.02750.x

Cited by 27 publications

(5 citation statements)

References 8 publications

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“…This is followed by multiple myeloma, extramedullary plasmacytoma, lymphoplasmocytic lymphoma/immunocytoma (including Waldenström’s macroglobulinemia), and B-cell chronic lymphocytic leukemia [2]. Rarely, secondary intraocular disease arises from intravascular lymphoma with secondary involvement of the eye [12, 13]. …”

Section: Nomenclaturementioning

confidence: 99%

Primary Vitreoretinal Lymphoma: A Report from an International Primary Central Nervous System Lymphoma Collaborative Group Symposium

et al. 2011

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Primary vitreoretinal lymphoma (PVRL), also known as primary intraocular lymphoma, is a rare malignancy typically classified as a diffuse large B-cell lymphoma and most frequently develops in elderly populations. PVRL commonly masquerades as posterior uveitis and has a unique tropism for the retina and central nervous system (CNS). Over 15% of primary CNS lymphoma patients develop intraocular lymphoma, usually occurring in the retina and/or vitreous. Conversely, 65%–90% of PVRL patients develop CNS lymphoma. Consequently, PVRL is often fatal because of ultimate CNS association. Current PVRL animal models are limited and require further development. Typical clinical findings include vitreous cellular infiltration (lymphoma and inflammatory cells) and subretinal tumor infiltration as determined using dilated fundoscopy, fluorescent angiography, and optical coherent tomography. Currently, PVRL is most often diagnosed using both histology to identify lymphoma cells in the vitreous or retina and immunohistochemistry to indicate monoclonality. Additional adjuncts in diagnosing PVRL exist, including elevation of interleukin-10 levels in ocular fluids and detection of IgH or T-cell receptor gene rearrangements in malignant cells. The optimal therapy for PVRL is not defined and requires the combined effort of oncologists and ophthalmologists. PVRL is sensitive to radiation therapy and exhibits high responsiveness to intravitreal methotrexate or rituximab. Although systemic chemotherapy alone can result in high response rates in patients with PVRL, there is a high relapse rate. Because of the disease rarity, international, multicenter, collaborative efforts are required to better understand the biology and pathogenesis of PVRL as well as to define both diagnostic markers and optimal therapies.

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Section: Nomenclaturementioning

confidence: 99%

Primary Vitreoretinal Lymphoma: A Report from an International Primary Central Nervous System Lymphoma Collaborative Group Symposium

et al. 2011

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“…Independent of the underlying disease, in some patients it may present as a pseudotumoral mass, mimicking a solid tumor, and therefore a differential diagnosis with other neoplasms must be taken into account [ 21 – 23 ]. A concurrent lymphoproliferative disorder and EMH in the same lesion has been described in only four case reports [ 24 – 27 ]. In one case [ 24 ] there was no history of a previous lymphoid neoplasm, and the development of the EMH probably was in the context of a hemorragic infarct secondary to a intravascular diffuse large B-cell lymphoma in the blood vessels of the uvea.…”

Section: Discussionmentioning

confidence: 99%

“…A concurrent lymphoproliferative disorder and EMH in the same lesion has been described in only four case reports [ 24 – 27 ]. In one case [ 24 ] there was no history of a previous lymphoid neoplasm, and the development of the EMH probably was in the context of a hemorragic infarct secondary to a intravascular diffuse large B-cell lymphoma in the blood vessels of the uvea. In the other three cases the lymphoproliferative disorder was previously known and the finding of EMH and a concurrent lymphoma was made afterwords.…”

Section: Discussionmentioning

confidence: 99%

Paraspinal extramedullary hematopoiesis in hereditary spherocytosis with a concurrent follicular lymphoma: case report and review of the literature

et al. 2015

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We report an unusual case of a 70-year-old male with history of hereditary spherocytosis (HS) and secondary paraspinal extramedullary hematopoiesis with a concurrent follicular lymphoma. The lesion presented as a thoracic paraspinal mass of 9 cm, extending longitudinally between T6 and T9 vertebral bodies. Incisional biopsy revealed that this mass included mature hematopoietic tissue compatible with extramedullary hematopoiesis (EMH). The tissue also presented an extensive and diffuse infiltration by an atypical lymphoid population composed predominantly by small cells. The immunohistochemical study revealed that the atypical lymphoid population had a germinal center phenotype, consistent with the diffuse variant of follicular lymphoma (FL). The simultaneous presence of both EMH and FL in the same lesion made the interpretation and the final diagnosis of this case difficult. The presence of EMH in this clinical context may eclipse the diagnosis of the underlying lymphoproliferative neoplasm. The close association between the tumor cells and extramedullary hematopoietic tissue in the absence of lymphadenopathies or other tissue involvement suggests a relationship of this tumor with the recently described primary FL of the bone marrow.

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“…4 Rare additional case reports have documented eye involvement, but the final diagnosis was made at autopsy or after treatment for other suspected disease. 16–18 …”

Section: Discussionmentioning

confidence: 99%

Diagnosis of Intravascular Lymphoma by a Novel Biopsy Site

et al. 2011

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Purpose To report the first known case of intravascular lymphoma (IVL), a rare disease, diagnosed via lacrimal gland biopsy. Design Interventional case report. Participants Single patient case report. Intervention Bedside lacrimal gland biopsy. Main Outcome Measures Clinicopathologic diagnosis of IVL, a neoplasm with only a few prior reports of ophthalmic manifestations, via a novel biopsy site. Results A 70-year-old Chinese man with 6 months of progressive paraplegia complained of blurred vision in both eyes. He had unremarkable cerebrospinal fluid studies and magnetic resonance imaging that showed abnormal thoracic cord signal and periventricular brain white matter changes with a normal pituitary gland and stalk. Dilated fundus examination showed multifocal areas of intra- and subretinal hemorrhage with serous retinal detachment. The workup included serologies and 2 normal bone marrow biopsies but did not reveal the underlying etiology. Because of the continued high suspicion for a malignant process, we performed bedside transconjunctival biopsy of the lacrimal gland. This demonstrated large, atypical CD20-positive B cells confined to the vessel lumina, consistent with IVL, an unusual form of large B-cell lymphoma. Conclusions This case represents the first time that IVL has been detected via lacrimal gland biopsy, which may be a useful way to investigate cryptogenic neurologic processes. Furthermore, it is one of the only reported cases of ophthalmic IVL diagnosed before autopsy. IVL is a rare disease but has protean manifestations involving the central nervous system, skin, bone marrow, liver, and spleen. The eye should also be considered an end organ for involvement.

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Correspondence

Cited by 27 publications

References 8 publications

Primary Vitreoretinal Lymphoma: A Report from an International Primary Central Nervous System Lymphoma Collaborative Group Symposium

Primary Vitreoretinal Lymphoma: A Report from an International Primary Central Nervous System Lymphoma Collaborative Group Symposium

Paraspinal extramedullary hematopoiesis in hereditary spherocytosis with a concurrent follicular lymphoma: case report and review of the literature

Diagnosis of Intravascular Lymphoma by a Novel Biopsy Site

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