词条 | Intraocular lymphoma |
释义 |
In immunocompetent patients, PIOL most commonly affects patients in their fifties and sixties. AIDS patients typically develop the disease earlier in their lives. PIOL affects the sub-retinal pigment epithelium (RPE), can invade into the retina, the vitreous, and the optic nerve. Ophthalmoscopy frequently reveals creamy yellow-to-orange colored subretinal infiltrates. Fluorescein angiography may reveal "leopard spot" patterns due to sub-RPE infiltrates that stain early and progressively or mottling of the RPE due to hyper- and hypofluorescent window defects.[2] PIOL is known as a masquerade syndrome because it frequently simulates the signs and symptoms of uveitis. As such, PIOL is frequently treated with corticosteroids. Occasionally, PIOL has mimicked a retinitis and has been treated with antiviral medication. It is not until the supposed uveitis fails to respond to treatment, becomes recalcitrant to treatment, or shows worsening with discontinuation of corticosteroid treatment that another cause is sought out. If PIOL is suspected, it is important to first obtain a magnetic resonance image (MRI) of the brain to rule out cerebral involvement (PCNSL). If MRI is negative, lumbar puncture with cerebrospinal fluid (CSF) cytology should be performed to further rule out CNS disease. Histopathologic identification of atypical lymphocytes is considered the gold standard for diagnosing PCNSL/PIOL. If CSF cytology is negative or inconclusive and PIOL is suspected, a vitrectomy is often performed with cytologic analysis. Furthermore, adjunctive testing including polymerase chain reaction (PCR) amplification to identify monoclonal rearrangements of the immunoglobulin heavy chain (IgH) gene (for B-cell lymphomas) or T-cell receptor (TCR, for the very rare T-cell lymphomas) can be performed.[3][4][5] Previously, radiation therapy was the mainstay treatment for PCNSL/PIOL, but methotrexate has now become first-line. References1. ^{{cite journal|last=Shen|first=DF|author2=Herbort, CP |author3=Tuaillon, N |author4=Buggage, RR |author5=Egwuagu, CE |author6= Chan, CC |title=Detection of Toxoplasma gondii DNA in primary intraocular B-cell lymphoma.|journal=Modern Pathology|date=Oct 2001|volume=14|issue=10|pages=995–9|pmid=11598169|url=http://www.nature.com/modpathol/journal/v14/n10/full/3880424a.html|accessdate=11 December 2012|doi=10.1038/modpathol.3880424}} {{Eye tumors}}{{DEFAULTSORT:Intraocular Lymphoma}}2. ^{{cite journal|last=Cassoux|first=N |author2=Merle-Beral, H |author3=Leblond, V |author4=Bodaghi, B |author5=Miléa, D |author6=Gerber, S |author7=Fardeau, C |author8=Reux, I |author9=Xuan, KH |author10=Chan, CC |author11=LeHoang, P|title=Ocular and central nervous system lymphoma: clinical features and diagnosis.|journal=Ocular Immunology and Inflammation|date=Dec 2000|volume=8|issue=4|pages=243–50|pmid=11262654|doi=10.1076/ocii.8.4.243.6463}} 3. ^{{cite journal|last=Shen|first=DF|author2=Zhuang, Z |author3=LeHoang, P |author4=Böni, R |author5=Zheng, S |author6=Nussenblatt, RB |author7= Chan, CC |title=Utility of microdissection and polymerase chain reaction for the detection of immunoglobulin gene rearrangement and translocation in primary intraocular lymphoma.|journal=Ophthalmology|date=Sep 1998|volume=105|issue=9|pages=1664–9|doi=10.1016/S0161-6420(98)99036-4|pmid=9754175}} 4. ^{{cite journal|last=Coupland|first=Sarah E.|author2=Anastassiou, Gerasimos |author3=Bornfeld, Norbert |author4=Hummel, Michael |author5= Stein, Harald |title=Primary intraocular lymphoma of T-cell type: report of a case and review of the literature|journal=Graefe's Archive for Clinical and Experimental Ophthalmology|date=March 2005|volume=243|issue=3|pages=189–197|doi=10.1007/s00417-004-0890-2|pmid=15806372}} 5. ^{{cite journal|last=Gonzales|first=John A.|author2=Chan, Chi-Chao|title=Biopsy techniques and yields in diagnosing primary intraocular lymphoma|journal=International Ophthalmology|date=August 2007|volume=27|issue=4|pages=241–250|doi=10.1007/s10792-007-9065-6|pmc=2048742|pmid=17440686}} 3 : Lymphoma|Ocular neoplasia|Epstein–Barr virus-associated diseases |
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