Título

OCULAR MASQUERADE SYNDROME AS A PRIMARY NON-HODGKIN LYMPHOMA OF TONSIL

Introdução / Purpose

Ocular masquerade syndrome is a group of rare diseases that occur with ocular inflammation and is often misdiagnosed as chronic uveitis.Many malignant entities such as non-Hodgkin’s lymphomas (NHL) may masquerade as uveitis.This report describes a patient with a rare metastasis of a NHL primary to the tonsil

Material e Método / Methods

61-year-old woman complained of blurred vision in the OR for a month (VA: light perception).Posterior synechias were identified and coarse cells grouped with rare hemorrhagic cells were found in the anterior vitreous.Ocular fundus examination revealed multiple whitish areas with a retinal detachment at the posterior pole and a large area of hemorrhage.Ultrasonography revealed a mass in the posterior pole and around the optic nerve and a perilesional retinal detachment.No abnormalities were found in OS. She had a history of a 5-year B-cell NHL primary of the tonsil, treated with chemo and radiotherapy. Infectious, autoimmune causes or systemic metastasis were excluded.Vitreous biopsy was negative for neoplastic cells.Two months later VA was no light perception and the patient complained of a severe ocular pain in OR, refractory to clinical treatment.An enucleation was performed with the anatomopathological study of diffuse B-cell NHL. She was referred to an oncologist to start a new cicle of chemotherapy

Resultados / Results

Ocular involvement by NHL is a rare condition, constituting less than 1% of all lymphomas. Intraocular metastasis of a primary tonsil NHL has never been reported in the compiled literature.Clinical manifestations include painless vision loss resulting from tumor infiltration of intraocular structures.The diagnosis is challenging and depends on the histopathology confirmation.Treatment usually includes radio/chemotherapy.But in a case of a painful blind eye refractory to clinical therapies, enucleation was an option

Discussão e Conclusões / Discussion

NHL often masquerades as uveitis resulting in misdiagnoses or delayed diagnosis with subsequent inappropriate management and mortality rates

Palavras Chave

uveitis;non-Hodgkin’s lymphomas;ocular masquerade syndrome

Area

CLINICAL RETINA