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Vol. 44. Issue S1.
Pages S30-S31 (October 2022)
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Vol. 44. Issue S1.
Pages S30-S31 (October 2022)
PP08
Open Access
AN UNUSUAL OCULAR LYMPHOMA, PRIMARY INTRAVITREAL LYMPHOMA DIAGNOSED INCIDENTALLY
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Nur Seda Ibili Cetinkaya1, Simge Erdem1, Nursema Deniz2, Berna Basarir3, Halil Özgür Artunay3, Tarık Onur Tiryaki1, Ali Emre Bardak2, Hazel Taş2, Meliha Nalcaci1, Sevgi Kalayoglu Besisik1
1 Istanbul University Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Hematology
2 Istanbul University Istanbul Faculty of Medicine, Department of Internal Medicine
3 University of Health Science, Beyoglu Eye Training and Research Hospital
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Vol. 44. Issue S1
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Objective

Ocular lymphoma involvement can be either secondary during systemic lymphoma or primary.

Diagnosis can be troublesome due to insidious disease onset. Uveitis is the main differential diagnosis.

The prognosis is poor.

Case report

A 62-year-old male patient was evaluated during a periodical check-up for hypertensive retinopathy. The unexpected good vision quality with severe left vitreous infiltration and not associated macular edema contributed to malignancy suspicion. A diagnostic procedure was performed bilaterally. Both of the vitreal tissue revealed atypical lymphoid cells with B-Cell phenotype. Cranial MRI, PET-CT, and CSF analysis documented the case as primary vitreoretinal lymphoma (VRL).

Methodology

First-line treatment was with intravitreal methotrexate (MTX). After 10 courses, high-dose cytarabine-based treatment was given as consolidation. Considering high recurrence rates, stem cells were mobilized and cryopreserved for future use for autologous stem cell transplantation (ASCT).

Results

Follow-up was 3 monthly. After 10 months of remission period, retinal disease relapse was spotted. After 5 cycles bilateral intravitreal MTX, disease progressed as leukemic invasion of left optic nerve. High dose chemotherapy followed by ASCT was performed.

Conclusion

Diagnosis of IVL is challenging due to late onset macular edema. Related with high relapse rates withhigh mortality, high-dose chemotherapy is the recommended management type currently.

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Idiomas
Hematology, Transfusion and Cell Therapy
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