Primary central nervous system lymphoma presenting as bilateral uveitis in an immunocompetent hepatitis C virus(+) patient: a case report.

Cases Journal
Guerriero SilvanaDomenico Santorsola

Abstract

To report a case of masquerade syndrome presenting as bilateral uveitis in an HCV positive patient, and to highlight the difficulties in distinguishing between chronic uveitis and malignancy-induced inflammation. In January 2005 a 54-year-old Caucasian man was referred to the Ophthalmological Department for bilateral visual loss, severe vitritis, and a significant cataract in both eyes. His clinical history was significant for HCV infection. The uveitis treated with low dose of steroids and immunosuppressors, yielding a partial remission of the symptoms. One year later he developed a Primary Central Nervous System Lymphoma. In January 2007 he returned to our department for cataract surgery. The patient underwent phacoemulsification of the cataract in the right eye, intraocular lens implantation and intravitreal injections of 4 mg triamcinolone acetonide. After one month fundus biomicroscopy showed a solid lesion at the posterior pole, consistent with a retinal relapse of the Primary Central Nervous System Lymphoma. Restaging investigations were unremarkable and ruled out a disease relapse, and a diagnostic vitrectomy showed only rare inflammatory cells. In view of the progressive swelling of the retinal lesions we decided to tr...Continue Reading

References

Oct 1, 1992·Archives of Ophthalmology·D J WilsonJ T Rosenbaum
Jun 1, 1988·Journal of Neurosurgery·F H Hochberg, D C Miller
Mar 5, 1998·The British Journal of Ophthalmology·P ZamiriS Lightman
Dec 19, 2002·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Lisa M DeAngelisUNKNOWN Radiation Therapy Oncology Group Study 93-10
Feb 18, 2003·Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft·H HelbigM D de Smet
Jul 3, 2003·Clinical Lymphoma·Adilia Hormigo, Lisa M DeAngelis
Sep 21, 2004·Cancer Control : Journal of the Moffitt Cancer Center·Chi-Chao Chan, Dana J Wallace
Feb 28, 2008·The British Journal of Ophthalmology·S FrenkelJ Pe'er

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Methods Mentioned

BETA
biopsy

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