K 701
Primary CNS Lymphoma (high grade B-Cell-non-Hodgkin's Lymphoma) with ocular involvementA. Petzold1, A. Zellner2, R. Lommatzsch1
Background: Of all intraocular lymphomas the large cell lymphoma occurs most frequently and is associated with a CNS-lymphoma or a systemic lymphoma. Vitreoretinal and uveal involvement can be distinguished, which are turning into each other in a later stage.
Patients: We demonstrate a 61 years-old female patient in whom a primary CNS-lymphoma was diagnosed in March 1999. After 6 cycles with a high-dose-chemotherapy complete remission was achieved and no sign of recurrence was noticed during a follow-up of 10 months. In December 1999 the patient suffered from deterioration of visual acuity of the right eye. Ophthalmoscopy revealed a subretinal lesion with leopard skin-like pigmented dots.
Results: After external beam radiotherapy of the dorsal part of the right eye with a total dose of 24 Gy a remission of the lymphoma could be observed ophthalmoscopically. Visual acuity increased from 0,32 to 1.0.
Conclusion: In elderly patients suffering from "uveitis" with unknown origin and no improvement after a systemic steroid therapy, an intraocular lymphoma has to be taken in consideration. Early radiotherapy can improve the prognosis regarding visual acuity of the eye being involved. Survival rate has also improved due to new therapeutic possibilities. Nevertheless, a curative therapy is not possible until now.
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Gemeinschaftspraxis Prof. Dr. P. Lommatzsch, Goldschmidstraße 30, D-04103 Leipzig