scholarly journals Case Report: Ocular Manifestations and Treatments of Ciliary Body Involvement by Lymphoma

2021 ◽  
Vol 11 ◽  
Author(s):  
Yu Di ◽  
Junjie Ye ◽  
Ruoan Han ◽  
Mengda Li ◽  
Bilei Zhang
Keyword(s):  
Visual Acuity ◽  
Ciliary Body ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Ultrasound Biomicroscopy ◽  
College Hospital ◽  
Medical College ◽  
Ocular Manifestations ◽  
Lymphomatous Involvement ◽  
Unilateral Involvement

PurposeTo describe the ocular clinical features, histopathological findings, and treatment outcomes of lymphomas involving the ciliary body.MethodsWe demonstrate three cases of ciliary body involvement by lymphoma from 2013 to 2019 in Peking Union Medical College Hospital (PUMCH). All patients underwent examinations including best corrected visual acuity (BCVA), slit-lamp microscopy, indirect ophthalmoscope, ultrasound biomicroscopy (UBM), and diagnostic vitrectomy. In addition, cytopathology, immunohistochemistry, gene rearrangement, cytometric immunophenotypic, or in-situ hybridization were used for determining the pathological type of lymphoma.ResultsThe patients were a 25-year-old man, a 52-year-old woman, and a 54-year-old man. Two patients had unilateral involvement, and one patient had bilateral involvement. All patients presented with anterior uveitis and elevated intraocular pressure. Ciliary body masses or infiltration were found in 3 patients. Two patients had diffuse large B-cell lymphoma and one patient had natural killer/T-cell lymphoma. All patients received 0.4 mg methotrexate intravitreal injections, and the ciliary body lesions regressed completely.ConclusionLymphomatous involvement of the ciliary body usually presents as an atypical anterior chamber reaction. Vitreous biopsy should be considered in these patients for diagnosis. Methotrexate intravitreal injection combine with chemotherapy or radiotherapy, might extend the survival time and preserve visual acuity for patients with ciliary body involvement by lymphoma.

scholarly journals Role of Immunohistochemistry in Staging Diffuse Large B-cell Lymphoma (DLBCL)

2008 ◽  
Vol 56 (10) ◽  
pp. 893-900 ◽  
Author(s):  
Dipti Talaulikar ◽  
Jane Esther Dahlstrom ◽  
Bruce Shadbolt ◽  
Amy Broomfield ◽  
Anne McDonald
Keyword(s):  
Bone Marrow ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Cox Regression Analysis ◽  
Cell Markers ◽  
Large B Cell Lymphoma ◽  
Lymphomatous Involvement ◽  
The Impact ◽  
Large B Cell

The use of immunohistochemistry (IHC) in staging bone marrow in non-Hodgkin's lymphoma (NHL) is largely limited to ambiguous cases, particularly those with lymphoid aggregates. Its role in routine clinical practice remains unestablished. This study aimed to determine whether the routine use of IHC in diffuse large B-cell lymphoma (DLBCL) would improve the detection of lymphomatous involvement in the bone marrow. It also sought to determine the impact of IHC on predicting survival compared with routine histological diagnosis using hematoxylin and eosin (H&E), Giemsa, and reticulin staining. The bone marrow trephines of 156 histologically proven DLBCL cases were assessed on routine histology, and IHC using two T-cell markers (CD45RO and CD3), two B-cell markers (CD20 and CD79a), and κ and λ light chains. IHC detected lymphomatous involvement on an additional 11% cases compared with histology alone. Although both routine histology and IHC were good predictors of survival, IHC was better at predicting survival on stepwise multivariate Cox regression analysis. IHC performed routinely on bone marrow trephines has the ability to improve detection of occult lymphoma in experienced hands. Furthermore, it is a better predictor of survival compared with routine histological examination alone.

scholarly journals Novel model predicts prognosis for patients with diffuse large B-cell lymphoma in first relapse after initial R-CHOP therapy: a single-institution study in China

2021 ◽  
Vol 49 (4) ◽  
pp. 030006052110029
Author(s):  
Wei Wang ◽  
Jingjing Yin ◽  
Wei Zhang ◽  
Yan Zhang ◽  
Daobin Zhou ◽  
...  
Keyword(s):  
B Cell ◽  
Prognostic Model ◽  
Cell Lymphoma ◽  
Progression Free Survival ◽  
B Cell Lymphoma ◽  
Chinese Patients ◽  
College Hospital ◽  
Large B Cell Lymphoma ◽  
Large B Cell ◽  
Chop Therapy

Objective To develop a prognostic model for Chinese patients with relapsed diffuse large B-cell lymphoma (DLBCL) after initial R-CHOP therapy. Methods We retrospectively analyzed the characteristics and survival outcomes of 79 patients with relapsed DLBCL initially treated with R-CHOP at Peking Union Medical College Hospital from February 2012 to September 2016. We used the data to develop a novel prognostic model. Results The median age at the start of salvage therapy was 59 (17–85) years and median time from diagnosis to relapse was 319 (49–1018) days. Multivariate analysis identified short time to relapse (TTR) and B symptoms as independent prognostic factors for reduced progression-free survival (PFS) and overall survival (OS). We created a new prognostic scoring system including TTR, lactate dehydrogenase, absolute lymphocyte count at relapse, and B symptoms, referred to as the TLLB model, which could separate patients into three risk groups with 2-year PFS and OS rates of 70.7%, 40.0%, and 11.1%, and 87.5%, 53.7%, and 29.4%, respectively. Conclusion TTR and B symptoms can be used as important predictors of survival in patients with DLBCL. The TLLB system provides a useful prognostic model compared with the previous TTL system.

scholarly journals Pattern of Immunophenotype Among the Cases of Lymphoma Attending in A Tertiary Level Hospital

2019 ◽  
Vol 17 (2) ◽  
pp. 21-25
Author(s):  
Shirajam Munira ◽  
Salama Afroze ◽  
Akhil Ranjon Biswas ◽  
MA Khan
Keyword(s):  
T Cell ◽  
B Cell ◽  
Hodgkin’S Lymphoma ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
T Cell Lymphoma ◽  
Hodgkin's Lymphoma ◽  
College Hospital ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma

Background : To explore the relative frequency and different forms of lymphoma in tertiary level hospital. Methods: This descriptive observational study was carried out in the Department of Hematology at Dhaka Medical College Hospital, Dhaka. Patients attended with solid tissue lymphoma in Outpatient, Inpatient and Lymphoma Clinic services of Department of Hematology and Bone Marrow Transplant, Dhaka Medical College Hospital, Dhaka were taken as study population as per inclusion criteria. A total of 63 patients with lymphoma diagnosed by histopathologically were selected initially, among them 53 were confirmed by immunohistochemistry taken as study population finally. Results: Mean age was 39.2 ± 15.5 years, median age was 36 years within the range of 14 – 75 years. Males were predominant. Male female ratio was 4.3:1. Most of the samples were collected from cervical lymph node (84.1%). Most of the patients came with fatigue and significant weight loss. Maximum 42 (79.24%) cases were Non-Hodgkin’s lymphoma and 11 (20.75%) cases were Hodgkin’s lymphoma. Out of 42 non-Hodgkin’s lymphoma, 27 (64.3%) were B-cell lymphoma and 15 (35.7%) were T-cell lymphoma. Among B-cell lymphoma, 19 (45.2%) were diffuse large B cell lymphoma, three (7.1%) were follicular lymphoma, three (7.1%) were mantle cell lymphoma, one (2.4%) was spleenic marginal zone lymphoma and one (2.4%) was Burkitt lymphoma. Among T-cell lymphoma, nine (21.4%) were peripheral T-cell lymphoma and six (14.3%) were adult T lymphoblastic lymphoma. Out of 11 Hodgkin’s lymphoma, 10 (90.9%) were classical Hodgkin’s lymphoma and one (9.1%) nodular lymphocyte predominant. Among classical Hodgkin’s lymphoma, five (45.5%) were mixed cellularity, three (27.3%) were lymphocyte predominant and two (18.2%) were Nodular sclerosis. Out of 42 non-Hodgkin’s lymphoma, 13 (30.95%) were indolent, 21 (50.00%) were aggressive and eight (19.05%) were very aggressive. Conclusion: In our study, it was found that 79.3% were non-Hodgkin lymphoma of which 64.3% were B-cell lymphoma & 35.7% were T-cell lymphoma and 20.7% cases were Hodgkin lymphoma of which 90.9% were classical Hodgkin’s lymphoma, 9.1% nodular lymphocyte predominant Hodgkin’s lymphoma. Chatt Maa Shi Hosp Med Coll J; Vol.17 (2); Jul 2018; Page 21-25

Bilateral Optic Nerve Invasion of Extranodal Marginal Zone B Cell Lymphoma with Leukemic Subtype

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 5285-5285
Author(s):  
Hwa Jung Sung ◽  
Eui Bae Kim ◽  
Se Ryeon Lee ◽  
Kyong Hwa Park ◽  
In Keun Choi ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Visual Acuity ◽  
Optic Nerve ◽  
Ct Scan ◽  
B Cell ◽  
Marginal Zone ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Nerve Invasion ◽  
Optic Disc Swelling

Abstract Extranodal marginal zone B cell lymphoma(MZBL), leukemic subtype is a rare B cell neoplasm characterized by peripheral lymphocytosis and bone marrow infiltration without nodal involvement. We report the case of a man who presented a simultaneous bilateral optic neuropathy as the initial clinical manifestation of extranodal MZBL. A 62-year-old man was referred to the Neuro-Ophthalmology Department because of a decrease in visual acuity, dyschromatopsia, visual field defects. Optic disc swelling was present in both eyes with peripapillary hemorrhages. Bilateral anterior ischemic optic neuropathy was diagnosed. Marked visual improvement occurred after 24 hours of intravenous methylprednisolone therapy, and vision completely recovered within a week. Eight weeks later, vision deteriorated again with bilateral optic disc swelling. A magnetic resonance image of the brain and orbit showed only enhancement of the optic nerve. Complete blood count(CBC) studies revealed hyperleukocytosis (13699/uL) with 72 % lymphocytes. There was no anemia and thrombocytopenia. Bone marrow(BM) study showed hypercellular with diffuse infiltration of small lymphocytic cells comprising 65.5% of all nucleasted cells. On immunophenotyping of BM aspirate, lymphocytic cells were CD2-CD3-CD5-CD10-CD23-CD33-CD34-CD117-CD138-cMPO-CD7+CD13+CD19+CD20+CD22+CD45+CD79+FMC7+kappa+lamda-. Cervicothoracic & abdominal CT scan showed no hepatosplenomegaly and no systemic lymphadenopathy. Depending on findings of BM and CT scan, extranodal marginal zone B cell lymphoma, leukemic subtype was diagnosed. Lumbar puncture revealed a white blood cell count of 790/uL with 90% lymphocyte. Flow cytometry was significant for a predominant population of CD3-CD4-CD8-CD20+CD13+ B-cell lymphocytes, diagnostic of cerebrospinal fluid involvement by lymphoma. So we could diagnosed the patient as optic nerve invasion of MZBL without optic nerve biopsy. The patient took several intrathecal chemotherapy with MHA(methotrexate, hydrocortisone, cytosine arabinoside)and 4th systemic treatment with R-CVP(rituximab, cyclophosphamide, prednosone). After all the visual acuity were improved and the infiltrative lesion of lymphoma on both optic nerve was found improved on the following MRI of orbit. The laboratory finding of CBC and CSF were completely normalized.

360° iris-ciliary body B-cell lymphoma masquerading as post-cataract uveitis

2004 ◽  
Vol 19 (3-4) ◽  
pp. 127-129 ◽  
Author(s):  
Muna Ahmed ◽  
Sofia Androudi ◽  
Periklis Brazitikos ◽  
Ian Paredes ◽  
Stephen Foster
Keyword(s):  
B Cell ◽  
Ciliary Body ◽  
Cell Lymphoma ◽  
B Cell Lymphoma

scholarly journals Ocular manifestations in Chinese adult patients with NLRP3-associated autoinflammatory disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tianli Meng ◽  
Di Wu ◽  
Yi Luo ◽  
Na Wu ◽  
Mengzhu Zhao ◽  
...  
Keyword(s):  
Autoinflammatory Disease ◽  
Adult Patients ◽  
Ocular Involvement ◽  
Autosomal Dominant Disorder ◽  
College Hospital ◽  
Multiple Systems ◽  
Medical College ◽  
Ocular Manifestations ◽  
Chinese Adult ◽  
Genetic Features

AbstractNLRP3-associated autoinflammatory disease (NLRP3-AID) is a rare autosomal dominant disorder involving multiple systems. We aim to assess the ocular manifestations of Chinese adult patients with NLRP3-AID. Twelve adult patients (> 18 years old) were diagnosed as NLRP3-AID at the Department of Rheumatology, Peking Union Medical College Hospital. All patients underwent ophthalmologic evaluation by an ophthalmologist. Clinical and genetic features of these patients were collected and compared with those from Caucasian population. A total of 7 NLRP3-AID patients (58%) 14 eyes had ocular manifestations. Five NLRP3 variants were identified, and 3 patients (43%) with severe ocular damages were all found to have the NLRP3 T348M variant. The incidences of papilledema and optic atrophy in the Chinese adult NLRP3-AID patients of moderate type were similar to those in the Caucasian NLRP3-AID patients of severe type. This is the first cohort of Chinese adult NLRP3-AID patients with ocular involvement. Ocular manifestations were diverse and even severe in NLRP3-AID, particularly in patients with the moderate phenotype, and may have relationship with genotypes. Awareness of these manifestations by rheumatologists and ophthalmologists could help to avoid the irreversible ocular damages.

scholarly journals Clinical features and treatment outcomes of intraocular lymphoma: a single-center experience in China

2021 ◽  
Vol 14 (4) ◽  
pp. 574-581
Author(s):  
Yu Di ◽  
◽  
Jun-Jie Ye ◽  
Meng-Da Li ◽  
◽  
...  
Keyword(s):  
Visual Acuity ◽  
Silicone Oil ◽  
Anterior Segment ◽  
Clinical Manifestations ◽  
Diagnostic Procedures ◽  
Intraocular Lymphoma ◽  
College Hospital ◽  
Medical College ◽  
Single Center Experience ◽  
Department Of Ophthalmology

AIM: To investigate the clinical manifestations, diagnostic approaches, treatments, and outcomes of intraocular lymphoma. METHODS: In this retrospective study, 16 patients (28 eyes) with intraocular lymphoma were recruited in the Department of Ophthalmology, Peking Union Medical College Hospital, from 2004 to 2019. All patients underwent comprehensive ophthalmic examinations. Vitreous specimens of 13 patients were sent for cytopathology examination and other adjunctive diagnostic procedures. Three patients were diagnosed with intraocular lymphoma according to analysis of the histopathological results of systemic lymphoma by one clinician. Twenty-three eyes were treated with intravitreal administration of methotrexate, 4 eyes could not receive ocular treatment due to life-threatening lymphoma, and 1 eye did not require ocular treatment because the fundus lesions regressed after systematic chemotherapy. RESULTS: In 28 eyes, 25 eyes were diagnosed with vitreoretinal lymphoma, and 3 eyes were diagnosed with ciliary body lymphoma, all of which were non-Hodgkin diffuse large B cell lymphomas. The final visual acuity improved in 15 eyes (54%), remained unchanged in 5 eyes (18%), and decreased in 8 eyes (29%). Anterior segment inflammation disappeared or reduced in 8 and 5 eyes, respectively; and 15 eyes had no anterior segment reaction. Twenty eyes had mild vitreous opacity, 1 eye had mild vitritis, and 7 eyes had pars plana vitrectomy combined with silicone oil tamponade. Fundus lesions disappeared in 9 eyes and were relieved in 5 eyes; 4 eyes showed no changes, and the remaining 10 eyes' fundus were normal. CONCLUSION: The clinical manifestations of intraocular lymphoma are diverse, and the misdiagnosis rate is high. Cytopathological analysis of vitreous is one of the gold standards for the diagnosis. Immunohistochemistry, gene rearrangement and flow cytometric immunophenotypic analysis can improve the diagnostic rate. Ocular chemotherapy or radiotherapy regimens may preserve visual acuity, and a multidisciplinary team can provide individualized treatment for the patients.

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