Spontaneous Regression Of Secondary Vitreoretinal Lymphoma After Diagnostic Vitrectomy: Case Report
Gan, L., & Ye, J. (2023). Spontaneous regression of secondary vitreoretinal lymphoma after diagnostic vitrectomy: case report. BMC ophthalmology, 23(1), 222. https://doi.org/10.1186/s12886-023-02967-5
View Original Source →Abstract
Our purpose is to report a patient with secondary intraocular mucosa-associated lymphoid tissue (MALT) who experienced spontaneous regression after diagnostic vitrectomy. We retrospectively reviewed the clinical and imaging features of the case. Multimodal imaging, including fundus photograph, optical coherence tomography, fundus fluorescein angiography and ultrasound scan was presented. A 71-year-old female presented with a subretinal lesion temporal to macula and scattered multifocal creamy lesions deep to retina in her left eye. Optical coherence tomography of the left eye showed multifocal nodular hyper-reflective signals between the Bruch’s membrane and RPE. She had a history of gastric MALT lymphoma. Diagnostic vitrectomy was performed. IL-10 level of aqueous was 187.7pg/ml. Cytology, gene rearrangement and flow cytometry of the vitreous were inconclusive. Systemic evaluation was normal. Secondary vitreoretinal MALT lymphoma was considered. Interestingly, her subretinal lesions regressed gradually without any chemotherapy. And IL-10 level of aqueous declined to 64.3pg/ml. Secondary vitreoretinal MALT lymphoma is extremely rare. Spontaneous regression of intraocular lymphoma does occur. The online version contains supplementary material available at 10.1186/s12886-023-02967-5.
Case Details
Disease Location
Eye
Personal Characteristics
71-year-old female, five years ago, she was diagnosed with gastric malt lymphoma. Her gastric lymphoma was staged as ann arbor ie and lugano ie
Clinical Characteristics
2-month history of painless blurred vision and an increasing nasal scotoma of her left eye. Best-corrected visual acuity (bcva) was 20/20 in right eye and 20/30 in left eye. Optical coherence tomography (oct) of the left eye showed elevated retina and hyper-reflective mass between bruch’s membrane and rpe temporal to the macula, as well as multifocal nodular hyper-reflective signals in the outer retina and beneath rpe. Secondary vitreoretinal lymphoma was suspected. Diagnostic ppv was performed. IL-10 level of aqueous sample was elevated. Cytology, gene rearrangement and flow cytometry for immunophenotyping of the vitreous sample were inconclusive. Three weeks after vitrectomy, the height of the temporal mass became lower, but more creamy lesions were observed at the upper quadrant corresponding with new nodular hyperreflective lesions on oct
Remission Characteristics
Six months after her presentation, her fundus revealed a residual area of pigmentation overlying the previous site of the subretinal lesions. Oct exhibited disruption of the photoreceptor/rpe layer; all nodular hyper-reflective signals disappeared.
Treatment & Mechanisms
Proposed Remission Mechanisms
Patient’s immune system against cancer is activated as a result of physical trauma caused by biopsy
Clinical Treatment
Diagnostic ppv