Nitrooční lymfom - klinická studie14 pacientů s NHL

Intraocular Lymphoma - a Study in 14 Patients with NHL

Aim:
To evaluate the course of clinical picture of intraocular lymphoma, possibilitiesof examination of this disease and the association with general symptoms ofthe non-Hodgkin lymphoma (NHL) in patients with manifestations of uveitis.Patients and Methods: a retrospective study in 14 patients followed in the periodof 1996 - 2001 in the Center for Diagnostics and Therapy of Uveitis, Ocular Clinicof General Faculty Hospital and 1st Medical Faculty, Charles University in Prague.Results: The group included 7 women and 7 men at the average age of 57.3 years(18-82) with clinical picture of uveitis. The time period fromthe first symptoms tothe diagnosis of NHL was 5 – 38 months (mean, 14.6 month). In two patients thediagnosis of systemic NHL preceded ocular symptoms, in four other patients thediagnosis of systemic or central nervous system NHL (CNS NHL) was establishedduring ocular manifestations of uveitis. Intraocular lymphoma was the only firstmanifestation of CNS NHL in six patients for the period of 9-34 months (mean, 15.2). Two patients have been so far affected by primary intraocular lymphoma(PIL) for 8 and 14 months respectively, and presently do not display any signs ofsystemic orCNSNHL. Clinical signs of intraocular inflammation of both eyes wereencountered in 71.4 % of patients. Vitritis (85.7 %) and tumor infiltration of retina(65.3 %) were the most frequent manifestations of NHL. Intraocular NHL wasdiagnosed on the basis of cytological examination of samples of intraocular fluidsin 8 patients (57.1 %). In four patients radiotherapy was applied onto 5 eyes andin 5 patients radiotherapy of CNS was used. Nine patients were treated withchemotherapy. 50 % of patients died until the end of 2001, the survival from theestablishment of diagnosis was 20.6 months on the average.Conclusions: intraocular lymphoma should be considered as the eye and life-threateningdisease. Cytological examination of intraocular fluids in patients withuveitis who do not respond to the therapy with steroids in the usual way may givemore precision and shorten the establishment of diagnosis in this masqueradesyndrome. Early diagnosis and therapy may improve the prognosis of NHL.

Key words:
uveitis, masquerade syndrome, intraocular lymphoma, non-Hodgkinlymphoma of CNS, systemic NHL, examination procedures,