Optic neuritis and systemic lymphoma.

A 26-year-old man with stage IV poorly differentiated lymphocytic lymphoma complained of visual loss of two weeks' duration. Examination revealed visual acuity of light perception in the right eye secondary to optic neuritis and other tests revealed the presence of lymphomatous leptomeningeal infiltration. Combined treatment with intrathecal methotrexate, prednisone, and whole brain radiation resulted in rapid long-lasting recovery of visual function of the right eye. The cerebrospinal fluid contained a large amount of thymus-derived lymphocytes and the subsequent clinical course observed with characteristic of T-cell or malignant lymphoblastic lymphoma.