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A Case of Intraocular Lymphoma Diagnosed by Subretinal Fluid Biopsy

Although intraocular lymphoma (IOL) mainly has have vitreous opacity and subretinal infiltration, its clinical symptoms are diverse. We report a case of IOL that mainly showed exudative retinal detachment in which analysis of IgH gene rearrangement (AIGHR) of the collected subretinal fluid sample wa...

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Autores principales: Inami, Wataru, Shibuya, Masayuki, Kumagai, Tomoyuki, Makita, Jun, Shinoda, Kei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8956477/
https://www.ncbi.nlm.nih.gov/pubmed/35345499
http://dx.doi.org/10.2147/IMCRJ.S345149
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author Inami, Wataru
Shibuya, Masayuki
Kumagai, Tomoyuki
Makita, Jun
Shinoda, Kei
author_facet Inami, Wataru
Shibuya, Masayuki
Kumagai, Tomoyuki
Makita, Jun
Shinoda, Kei
author_sort Inami, Wataru
collection PubMed
description Although intraocular lymphoma (IOL) mainly has have vitreous opacity and subretinal infiltration, its clinical symptoms are diverse. We report a case of IOL that mainly showed exudative retinal detachment in which analysis of IgH gene rearrangement (AIGHR) of the collected subretinal fluid sample was useful for diagnosis. A 77-year-old woman developed decreased left visual acuity for 1 month. She had been treated for dermatomyositis, diabetes mellitus, and right parotid tumor for 3 years. Visual acuity was 0.1 OD and counting fingers OS. Slit-lamp examination showed grade 4 (Emery-Little classification) nuclear cataract in both eyes and keratoprecipitates and tan vitreous opacity in the left eye. Fundoscopy details were unclear except for a vaguely observable optic nerve head due to yellow-brown vitreous opacity, which we judged as an old vitreous hemorrhage. Phacovitrectomy was performed and almost total retinal detachment was found, except for a part of the superior periphery. Since no retinal break was found and a wide range of thin membrane-like tissue was found on the surface of the retina, the surgeon suspected primary IOL and performed unplanned biopsy. The peripheral vitreous was collected as a sample, and then the subretinal fluid was collected through an intentional break to prevent mixing with other fluids. The subretinal strand was gently removed and collected. Cytology showed class III, the IL10/IL6 ratio was low, and AIGHR was positive. Postoperatively, fundus autofluorescence showed no abnormality, no leakage was observed on fluorescein and indocyanine green angiography, and the location of typical infiltration lesions under the retina was unclear. There were no positive findings on systemic examinations and a diagnosis of primary IOL was made. The main symptoms of this case were vitreous opacity and exudative retinal detachment, and AIGHR using subretinal fluid was useful for diagnosis.
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spelling pubmed-89564772022-03-27 A Case of Intraocular Lymphoma Diagnosed by Subretinal Fluid Biopsy Inami, Wataru Shibuya, Masayuki Kumagai, Tomoyuki Makita, Jun Shinoda, Kei Int Med Case Rep J Case Report Although intraocular lymphoma (IOL) mainly has have vitreous opacity and subretinal infiltration, its clinical symptoms are diverse. We report a case of IOL that mainly showed exudative retinal detachment in which analysis of IgH gene rearrangement (AIGHR) of the collected subretinal fluid sample was useful for diagnosis. A 77-year-old woman developed decreased left visual acuity for 1 month. She had been treated for dermatomyositis, diabetes mellitus, and right parotid tumor for 3 years. Visual acuity was 0.1 OD and counting fingers OS. Slit-lamp examination showed grade 4 (Emery-Little classification) nuclear cataract in both eyes and keratoprecipitates and tan vitreous opacity in the left eye. Fundoscopy details were unclear except for a vaguely observable optic nerve head due to yellow-brown vitreous opacity, which we judged as an old vitreous hemorrhage. Phacovitrectomy was performed and almost total retinal detachment was found, except for a part of the superior periphery. Since no retinal break was found and a wide range of thin membrane-like tissue was found on the surface of the retina, the surgeon suspected primary IOL and performed unplanned biopsy. The peripheral vitreous was collected as a sample, and then the subretinal fluid was collected through an intentional break to prevent mixing with other fluids. The subretinal strand was gently removed and collected. Cytology showed class III, the IL10/IL6 ratio was low, and AIGHR was positive. Postoperatively, fundus autofluorescence showed no abnormality, no leakage was observed on fluorescein and indocyanine green angiography, and the location of typical infiltration lesions under the retina was unclear. There were no positive findings on systemic examinations and a diagnosis of primary IOL was made. The main symptoms of this case were vitreous opacity and exudative retinal detachment, and AIGHR using subretinal fluid was useful for diagnosis. Dove 2022-03-21 /pmc/articles/PMC8956477/ /pubmed/35345499 http://dx.doi.org/10.2147/IMCRJ.S345149 Text en © 2022 Inami et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Case Report
Inami, Wataru
Shibuya, Masayuki
Kumagai, Tomoyuki
Makita, Jun
Shinoda, Kei
A Case of Intraocular Lymphoma Diagnosed by Subretinal Fluid Biopsy
title A Case of Intraocular Lymphoma Diagnosed by Subretinal Fluid Biopsy
title_full A Case of Intraocular Lymphoma Diagnosed by Subretinal Fluid Biopsy
title_fullStr A Case of Intraocular Lymphoma Diagnosed by Subretinal Fluid Biopsy
title_full_unstemmed A Case of Intraocular Lymphoma Diagnosed by Subretinal Fluid Biopsy
title_short A Case of Intraocular Lymphoma Diagnosed by Subretinal Fluid Biopsy
title_sort case of intraocular lymphoma diagnosed by subretinal fluid biopsy
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8956477/
https://www.ncbi.nlm.nih.gov/pubmed/35345499
http://dx.doi.org/10.2147/IMCRJ.S345149
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