PMC6816004_01
(a) Ultra-wide field pseudocolor retinography of the right eye of a 42 year-old black male. Currently in systemic remission, he was diagnosed with peripheral blood diffuse large B-cell lymphoma (DLBCL) 10 months before. Creamy whitish subretinal infiltrates with some hemorrhages suggested secondary metastatic retinal lymphoma (SRML). (b) Swept-source optical coherence tomography showed a sheet of vitreous cells. (c) Retinal biopsy (Hematoxylin-Eosin, 200x) confirmed intraocular diffuse large B-cell lymphoma. Note the large atypical cells admixed with coagulative necrosis. Bar size = 100 mum. (d) The cell showed a diffuse and strong positivity for CD20. Bar size = 100 mum. (e) Vitreous cytology (Diff-quick, 600x), atypical large cells with variable morphology and accompanying lymphocytes. Bar size = 50 mum. (f) Vitreous cytology of the same sample (Diff-quick, 400x) showing multiple lymphocytes and macrophages. Bar size = 50 mum.
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fig1
Vitreous haze was found in 24/32, 75%, retinal involvement appeared in 9/32, 28% of the eyes, 7 of them with vasculitis-like lesions (7/32, 21%) and subretinal infiltration in 8/32 (25%) (Figure 1).
(a) Ultra-wide field pseudocolor retinography. Frosted-branch angiitis in the right eye of a 44-year-old woman complaining of blurry vision the last month. She has a completely remission of natural killer T-cell cavum lymphoma. (b) Vitreous cytology (Papanicolau 400x) confirmed atypical lymphoid cells. (c) In situ hibridation for Epstein-Barr Virus (EBER) was positive in the atypical cells (400x). (d) The cells showed a diffuse and strong positivity for CD3.
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T-cell lymphoma case (Figure 2). There were no significant differences between groups regarding anterior chamber cells, vitreous haze nor retinal/vascular involvement.
(a) Ultra-wide field pseudocolor retinography. Choroidal mass infiltration in the left eye of a 46-year-old man complaining of visual impairment during the past 36 months. (b) Anterior segment biomicroscopy showed subconjunctival salmon plaque, a primary uveal lymphoma with extraocular infiltration was suspected. (c) SD-OCT showed dome shaped pattern due to massive choroidal infiltration. (d) Teno-conjunctival biopsy (Hematoxylin& Eosin, 100x) yielded an extranodal marginal zone lymphoma, composed of sheets of homogeneous medium to small lymphocytes. Bar size = 100 mum. (e) CD20 B-cell marker was strongly positive (100x). Bar size = 100 mum.
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Deep choroidal infiltration was seen in 4/4, 100% of the eyes with PUL, whereas only in 1/17, 5% of the eyes with PVRL (p < 0.001) and 1/11, 9% with SMRL (p=0.003) (Figure 3).