Desprendimiento seroso macular bilateral como forma de presentación de linfoma B difuso de célula grande / Diffuse large B cell lymphoma presenting with a bilateral serous macular detachment

RESUMEN

Caso clínico Un varón de 42 años fue atendido por pérdida visual bilateral subaguda. Como antecedentes presentaba una hepatitis C crónica activa y un síndrome de Evans. Mediante funduscopia se observaron múltiples focos de desprendimiento neurosensorial y de EPR en ambas polos posteriores. A los pocos días empeoró su estado general (fiebre alta y múltiples adenopatías). La biopsia de las adenopatías laterocervicales objetivó un linfoma B difuso de células grandes. Se le trató con quimioterapia y experimentó una paulatina reaplicación de los focos de desprendimiento seroso con mejoría visual progresiva. Discusión: El desprendimiento seroso macular bilateral puede ser una manifestación precoz de un linfoma B difuso de célula grande. El curso de estas lesiones intraoculares puede ser favorable con la remisión del linfoma

ABSTRACT

Clinical case A 42 year-old male was assessed for a subacute, bilateral and progressive visual loss. His medical history included chronic hepatitis C infection and Evans syndrome. On fundal examination, multiple areas of neurosensorial and retinal pigmented epithelium detachment were observed in the region of both macula. A few days later, his general health deteriorated and he was noted to have a high fever and adenopathy. Biopsy of an enlarged lateral cervical lymph node demonstrated the existence of a diffuse large B cell lymphoma. After several cycles of chemotherapy, he experienced a progressive and bilateral improvement of his vision, which was accompanied by a reattachment of the previously detached areas. Discussion: A bilateral and serous macular detachment may be the initial manifestation of a diffuse large B cell lymphoma. The prognosis of these retinal lesions may be favourable if lymphoma remission is achieved