Necrotic Malignant Melanoma of the Choroid and Concurrent Intraocular Manifestation of Malignant Non-Hodgkin’s B Cell Lymphoma

Abstract

An 80-year-old white female developed clinical signs of a large choroidal malignant melanoma in her left eye. There were no signs of metastatic disease but an asymptomatic chronic lymphatic leukemia was discovered. Histopathologic examination of the enucleated left eye showed a mostly necrotic malignant melanoma of the choroid with areas of spindle B cell differentiation, episcleral extension and secondary angle-closure glaucoma with necrosis of the anterior segment of the eye. On the basis of immunocytochemical studies of the lymphocytic infiltrates in the iridal blood vessels, retinal blood vessels and the choroid, the leukemic disease was classified as B cell lymphoma of low malignancy (lymphoplasmacytoid immunocytoma). A reactive T lymphocytic infiltration of the conjunctival stroma was also noted. Patients with malignant melanomas of the uvea require exclusion of a second malignancy.

Concomitant Choroidal Melanoma and Non-Hodgkin Lymphoma in Two Adult Patients: Case Report

“…A literature search on patients with a choroidal melanoma and simultaneous primary or secondary intraocular lymphoma delivered us only one case report describing a patient with choroidal (necrotic) melanoma concomitant with asymptomatic systemic B-cell lymphoma [6]. In this report the NHL was clinically undetected and the diagnosis of NHL was obtained by histopathologic examination of the enucleated eye.…”

Intraocular Tumors and Glaucoma

“…Aköz sıvı örneklerinde de fagosite edilmiş ve serbest hâlde bulunan melanin pigmentleri gösterilmiştir. 6,8,9 Uveal melanositomalar koyu pigmentli izole lezyonlar olarak görülürler. Nekroz ve fragmantas-yona gitme eğiliminde oldukları için pigment salınımına sıklıkla neden olurlar.…”