A Case of Primary Central Nervous System Lymphoma with Ocular Involvement

ABSTRACT

PURPOSE: To report one case of primary central nervous system lymphoma with ocular involvement confirmed by pars plana vitrectomy. METHODS: A 52-year-old healthy man visited our hospital complaining of progressive dysarthria, memory impairment, and chronic headache. Brain CT scans and MRI scans revealed a brain tumor in the left basal ganglia and the frontal lobe. Stereotactic biopsy of the tumor showed a large diffuse B-cell type malignant lymphoma. Three months later, he presented with decreased vision and sensation of floaters in the right eye. Funduscopic examination of the right eye revealed a vitreous opacity peripherally. He underwent pars plana vitrectomy and vitreous biopsy to rule out ocular involvement of lymphoma. Smears from the cytospin of the specimen prepared from vitrectomy in the right eye showed a greater number of large, pleomorphic lymphoid cells. Flow cytometric immunophenotyping showed a clonal population of CD 20 which was conclusive for infiltration with B-cell lymphoma. RESULTS: The patient underwent treatment with radiotherapy to the brain and the right eye in combination with systemic and intrathecal chemotherapy. After five cycles of chemotherapy and radiotherapy, the brain mass disappeared, the neurological symptoms were improved, and the visual acuity of the right eye increased.