Iris involvement by lymphoma: a review of 13 cases

作者:Mashayekhi Arman*; Shields Carol L; Shields Jerry A
来源:Clinical and Experimental Ophthalmology, 2013, 41(1): 19-26.
DOI:10.1111/j.1442-9071.2012.02811.x

摘要

Background: To describe the clinical and histopathological features of lymphomas involving the iris. Design: Retrospective, descriptive study. Participants: Fourteen eyes of 13 patients. Methods: Review of medical records. Main Outcome Measures: Clinical and histopathological findings. Results: Median patient age was 58 years (range, 2576 years). Seven patients had known systemic lymphoma of which five were of large B-cell type. Symptoms included blurred vision (8/14), eye redness (3/14) and eye pain (2/14). Four eyes had secondary elevated intraocular pressure. Anterior segment findings included anterior chamber cells (14/14 eyes), keratic precipitates (11/14 eyes), congestion of conjunctival/episcleral blood vessels (9/14), hyphaema (7/14), conjunctival/anterior epibulbar lymphoma (6/14), tumour-induced pseudohypopyon (4/14) and corneal oedema (3/14). Of 12 eyes with adequate view of iris details, clinically detectable iris thickening or visible mass was noted in all (12/12). There was concomitant involvement of ciliary body (8/14), choroid (5/14) and orbit (2/14). All patients had biopsy of conjunctiva, episclera, iris or ciliary body, confirming the diagnosis of lymphoma. Histopathological or cytopathological evaluation of iris or ciliary body showed high-grade lymphoma in 9/11 eyes in which it was performed. Five patients did not have long-term follow up and, of the other eight patients, three died from complications of systemic lymphoma during follow up ranging from 1 to 44 months. Conclusion: Lymphomatous involvement of the iris should be considered in the differential diagnosis of corticosteroid-resistant uveitis in middle-aged and elderly patients. Iris lymphoma tends to be high grade and usually develops in patients with known aggressive systemic lymphoma.

  • 出版日期2013-2