Intravascular Lymphoma Masquerading as Vogt-Koyanagi-Harada Syndrome

Pahk, Patricia J.; Todd, Derrick J.; Blaha, Gregory R.; Soukiasian, Sarkis H.; Landmann, Dan S.; Craven, Donald E.; Tronic, Bruce S.; Zabar, Yuval; Marx, Jeffrey L.

doi:10.1080/09273940802023810

Cited by 20 publications

(11 citation statements)

References 6 publications

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“…Although both VKH and SO have similar clinical manifestations, the diseases may prove to have different etiology. In patients with VKH, associations with other autoimmune disorders and malignancies have been reported among dark-skinned individuals [3][4][5][6][7][10][11][12]. In this study, we found two cases of choroidal malignant melanoma among patients with VKH.…”

Section: Discussionsupporting

confidence: 54%

“…The disease may be associated with signs of meningeal irritation with or without auditory disturbances and skin changes. Associations with other autoimmune disorders and malignancies have been reported [3][4][5][6][7][8][9][10][11]. The clinical manifestations of VKH are well outlined and the exact etiology of this condition remains to Electronic supplementary material The online version of this article (doi:10.1007/s00417-011-1727-4) contains supplementary material, which is available to authorized users.…”

Section: Introductionmentioning

confidence: 99%

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The association of systemic disorders with Vogt–Koyanagi–Harada and sympathetic ophthalmia

Al-Halafi

Dhibi

Hamade

et al. 2011

Graefes Arch Clin Exp Ophthalmol

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Section: Discussionsupporting

confidence: 54%

Section: Introductionmentioning

confidence: 99%

The association of systemic disorders with Vogt–Koyanagi–Harada and sympathetic ophthalmia

Al-Halafi

Dhibi

Hamade

et al. 2011

Graefes Arch Clin Exp Ophthalmol

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“…Intraocular lymphoma can arise primarily within the CNS, where it is either primary intraocular lymphoma or primary CNS lymphoma or from outside the CNS with ocular metastasis [9,76,83,[94][95][96][97]. Regardless of the origin, intraocular lymphoma tends to present bilaterally (80%) as either an intermediate and/or posterior uveitis.…”

Section: Grillo Levinson and Gordonmentioning

confidence: 99%

“…HIV testing should also be considered in otherwise healthy individuals presenting with suspected endogenous endophthalmitis. Other important considerations in the differential diagnosis are masquerade syndromes and primary intraocular B-cell lymphoma [10,76,94].…”

Section: Reviewmentioning

confidence: 99%

Practical diagnostic approach to uveitis

Grillo

Levinson

Gordon³

2011

Expert Review of Ophthalmology

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Accounting for approximately 10% of blindness in the USA, uveitis refers to a group of heterogeneous diseases that share the features of intraocular inflammation but whose etiologies include idiopathic autoimmune disease, infections, rheumatologic diseases and masquerade syndromes. Correct diagnosis with timely and appropriate therapy is key to reducing diseaseassociated morbidity. The multitude of possible causes can create diagnostic challenges, but a successful approach includes a targeted history of the illness and associated symptoms, detailed ocular evaluation and specific laboratory investigations. The purpose of this article is to aid in the initial evaluation and decision-making strategy for uveitis according to the Standardization of Uveitis Nomenclature Working Group classification scheme and to provide a brief look at the anticipated future for diagnostic tools.

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“…All reported cases of ophthalmologic IVLBCL have involved other organ systems or were not completely staged to rule out systemic involvement [4][5][6][7][8][9][10][11]. Most cases of ophthalmologic IVLBCL were not diagnosed by biopsy of an ophthalmologic structure, but at either autopsy or the patient's ophthalmologic signs and symptoms were correlated with eye involvement after a biopsy of another organ system established the diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Isolated intraorbital intravascular large B-cell lymphoma: a case report

2011

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Intravascular large B-cell lymphoma is a rare Bcell lymphoma subtype characterized by tumor cells found exclusively within vascular lumina. We report the case of an 88-year-old woman who initially presented with pain, swelling, and loss of vision in her left eye. A left orbital mass was revealed by computed tomography, and a biopsy was performed. On histologic examination, large atypical lymphoid cells were present in blood vessel lumina of the intraorbital adipose tissue. No tumor cells were seen in the surrounding tissue. By immunohistochemistry, the tumor cells were positive for CD20, BCL-2, Bcl-6, and CD5; they were negative for CD10 and cyclin D1. Ki-67 revealed a proliferation rate of approximately 80-90%, and CD31 highlighted the vascular endothelium. These findings confirmed the diagnosis of intravascular large B-cell lymphoma. Results of bone marrow and cerebrospinal fluid examinations were negative for involvement, and there was no radiographic evidence of systemic disease.The patient received systemic treatment with etoposide, doxorubicin, vincristine, cyclophosphamide, prednisone, and rituximab in addition to intrathecal methotrexate. The patient had resolution of her intraorbital mass. While it is understood that this disease can involve any organ, only very rarely does intravascular large B-cell lymphoma present with primary ophthalmologic symptoms. Additionally, this patient's disease initially appeared to be isolated, with no skin manifestations or other systemic involvement. To our knowledge, this is the first reported case in which this disease manifested as an isolated intraorbital mass without detectable involvement of any other organ.

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Intravascular Lymphoma Masquerading as Vogt-Koyanagi-Harada Syndrome

Abstract: Intravascular lymphoma can present as a masquerade of VKH syndrome. Diagnosis can be aided with measurement of LDH and skin biopsy.

Cited by 20 publications

References 6 publications

The association of systemic disorders with Vogt–Koyanagi–Harada and sympathetic ophthalmia

The association of systemic disorders with Vogt–Koyanagi–Harada and sympathetic ophthalmia

Practical diagnostic approach to uveitis

Isolated intraorbital intravascular large B-cell lymphoma: a case report

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