Abstract
A case is presented of an intraocular T-cell lymphoma mimicking a ring melanoma of the iris and being the first manifestation of systemic disease. A 51-year-old woman was referred with an anterior uveitis, initially presenting as a granulomatous iritis. Nodules had developed in the circumference and the lesion now imitated a malignant melanoma of the iris, which was also the diagnosis from a biopsy specimen with routine staining. Clinical, haematological and serologcial examination revealed no other symptoms or signs. Lymphocytic markers applied to the biopsy specimen and to the enucleated eye revealed a highly malignant T-cell lymphoma infiltrating the iris, ciliary body, anterior choroid, retina and the adjacent vitreous body. Further examination later showed T-cell lymphoma in the bone marrow, the only other organ involved. The patient died in a leukaemic phase about 1 year after the first admission. Previous cases of T-cell lymphoma with ocular involvement are reviewed.
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References
Chan JKC, NG CS, Hui PK (1988) A simple guide to the terminology and application of leucocyte monoclonal antibodies. Histopathology 12:461–480
Erny BC, Egbert PR, Peat IM, Shorrock K, Rosenthal AR (1991) Intraocular involvement with subretinal pigment epithelium infiltrates by mycosis fungoides. Br J Ophthalmol 75:698–701
Foerster HC (1960) Mycosis fungoides with intraocular involvement. Trans Am Acad Ophthalmol Otol 308–313
Fradkin AH, Ruiz RS, Sloane JA (1969) Mycosis fungoides involving the caruncle. Am J Ophthalmol 68:719–722
Gärtner J (1989) Mycosis fungoides mit Beteiligung der Aderhaut. Klin Monatsbl Augenheilkd 131:61–69
Goldey SH, Stern GA, Oblon DJ Mendenhall NP, Smith LJ, Duque RE (1989) Immunophenotypic characterization of an unusual T-cell lymphoma presenting as anterior uveitis. A clinicopathologic case report. Arch Ophthalmol 107:1349–1353
Henderson JW, Banks PM, Yeatts RP (1989) T-Cell lymphoma of the orbit. Mayo Clin Proc 64:940–944
Kaplan HJ, Travis MA, Aaberg TM, Keller RH (1980) Reclassification of intraocular reticulum cell sarcoma (histiocytic lymphoma). Immunologic characterization of vitreous cells. Arch Ophthalmol 98:707–710
Keltner JL, Fritsch E, Cykiert RC, Albert DM (1977) Mycosis fungoides. Intraocular and central nervous system involvement. Arch Ophthalmol 95:645–650
Kirsch LS, Brownstein S, Codère F (1990) Immunoblastic T-cell lymphoma presenting as an eyelid tumor. Ophthalmology 97:1354–1357
Lauer SA, Fischer J, Jones J, Gartner S, Dutche J, Hoxie JA (1988) Orbital T-cell lymphoma in human T-cell leukemia virus-1 infection. Ophthalmology 95:110–115
Leitch RJ, Rennie IG, Parsons MA (1993) Ocular involvement in mycosis fungoides. Br J Ophthalmol 77:126–127
Lennert K, Feller AC (1992) Histopathology of non-Hodgkin's lymphomas (based on the updated Kiel classification). Springer, Berlin Heidelberg New York, p 40
Meekins B, Proia AD, Klintworth GK (1985) Cutaneous T-cell lymphoma presenting as a rapidly enlarging ocular adnexal tumor. Ophthalmology 92:1290–1293
Michelson JB, Michelson PE, Bordin GM, Chisari FV (1981) Ocular reticulum sarcoma. Presentation as retinal detachment with demonstration of monoclonal immunoglobulin light chains on the vitreous cells. Arch Ophthalmol 99:1409–1411
Norton AJ, Isaacson PG (1989) Lymphoma phenotyping in formalin-fixed and paraffin wax-embedded tissues. I. Range of antibodies and staining patterns. Histopathology 14:437–446
Pan H, Tillmann W, Goerz G (1976) Mycosis fungoides mit Befall des Auges und innerer Organe. Klin Monatsbl Augenheilkd 168:706–712
Reim H, Dieler R, Wessing A (1990) Non-Hodgkin-Lymphom mit dem Erscheinungsbild einer Chorioretinitis. Fortschr Ophthalmol 87:557–559
Ridley ME, McDonald HR, Sternberg P, Blumenkranz MS, Zarbin MA, Schachat AP (1992) Retinal manifestations of ocular lymphoma (reticulum cell sarcoma). Ophthalmology 99:1153–1161
Saga T, Ohno S, Matsuda H, Ogasawara M, Kikuchi K (1984) Ocular involvement by a peripheral T-cell lymphoma. Arch Ophthalmol 102:399–402
Scherfig E, Bauer B, Bengtsson-Stigmar E, Jensen OA, Johnsson A, Prause JU (1987) Trilateral malignant lymphoma: primary malignant B-cell lymphoma of the eyes and brain. Diagnosis by transvitreal retinochoroidal biopsy. Ophthalmologica 195:135–140
Sherman MD, Van Dalen JTW, Conrad K (1990) Bilateral orbital infiltration as the initial sign of a peripheral T-cell lymphoma presenting in a leukemic phase. Ann Ophthalmol 22:93–95
Sloas HA, Starling J, Harper DG, Cupples HP (1981) Update of ocular reticulum cell sarcoma. Arch Ophthalmol 99:1048–1952
Stenson S, Ramsay DL (1981) Ocular findings in mycosis fungoides. Arch Ophthalmol 99:272–277
Trudeau M, Shepherd FA, Blackstein ME, Gospodarowicz M, Fitzpatrick P, Moffatt KIP (1988) Intraocular lymphoma: report of three cases and review of the literature. Am J Clin Oncol 11:126–130
Vogel MH, Front RL, Zimmerman LE, Levine RA (1968) Reticulum cell sarcoma of the retina and uvea. Am J Ophthalmol 66:205–215
Whitbeck EG, Spiers ASD, Hussain M (1983) Mycosis fungoides: subcutaneous and visceral tumors, orbital involvement, and ophthalmoplegia. J Clin Oncol 1:270–276
Wolter JR, Leenhouts TM, Hendrix RC (1963) Corneal involvement in mycosis fungoides. Am J Ophthalmol 55:315–322
Zucker JL, Doyle MF (1991) Mycosis fungoides metastatic to the orbit. Arch Ophthalmol 109:688–691
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Jensen, O.A., Johansen, S. & Kiss, K. Intraocular T-cell lymphoma mimicking a ring melanoma. First manifestation of systemic disease. Graefe's Arch Clin Exp Ophthalmol 232, 148–152 (1994). https://doi.org/10.1007/BF00176784
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DOI: https://doi.org/10.1007/BF00176784