Background: Although B-cell lymphomas are the most frequent cancers that evolve in transplant patients, histopathologic verification of intraocular lymphoma as a result of cyclosporine immunosuppression has not been previously recognized.
Methods: A complete autopsy was performed on a 67-year-old woman who died 33 months after orthotopic heart transplantation.
Findings: Large cell lymphoma extensively involved the anterior segment of the left eye, as well as the vitreous, retina, subretinal pigment epithelial zone, and optic nerve. Tumor also was found in the ipsilateral orbitofrontal cortex and hypothalamic areas. No systemic lymphoma was present.
Conclusion: Ocular and central nervous system lymphoma developed in a heart transplant patient. In addition to opportunistic infections, ophthalmologists should be aware that opportunistic lymphoproliferative disorders involving the eye and brain can occur in these immunosuppressed individuals. Epstein-Barr virus infection has been implicated as playing a major role.