Presentation
Case Presentation: 60 year old African American man with history of HTN, HLD, and mitral valve regurgitation presented to the ER complaining of 2.5 weeks of progressively worsening right eye pain and swelling. [shmabstracts.com]
When lymphomas are present on the eye and nowhere else, they are treated with EBRT-external beam radiation therapy. [verywellhealth.com]
If concomitant brain involvement is present high dose methotrexate should be used, followed by radiation to the involved globe if response is less than complete. [bccancer.bc.ca]
Systemic Malignancies / Lymphomatous Tumors Third CORE Category: Intraocular Inflammation and Uveitis / Masquerade Syndromes / Neoplastic Masquerade Syndromes Diagnosis: Ocular lymphoma Brief Description: This is a case report of an elderly male who presented [morancore.utah.edu]
The high incidence of metastasis, the spread of the cancer from the eye to the brain through the dissemination of tumorous cells, is a problem presented by this disease—dispersal of cancer cells to the brain occurs in 65-80 percent of cases within 29 [u-tokyo.ac.jp]
Entire Body System
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Physician
of the Oncology Institute of Southern Switzerland, write, "While doxycycline appears to be an easy-to-implement therapeutic approach, we strongly encourage all physicians to enroll patients in clinical prospective trials to help answer these questions [sciencedaily.com]
He originally saw his primary care physician, who prescribed him eye drops. However, the swelling got worse, so his PMD referred him to an optometrist, who prescribed him PO doxycycline. However, the swelling continued to worsen. [shmabstracts.com]
Several of the attending physicians mentioned that they have been observing certain patients with small to moderately sized, biopsy proven conjunctival MALT lymphomas without treatment. [eyecancercure.com]
Schefler has hand selected her team of physicians to provide patients in the Houston, TX area and beyond with cancer care that is unparalleled to other practices. [houstonretina.com]
In case of severe complications, it may result in vision loss Chemotherapy, surgery, radiation therapy, and other treatment measures may be used for treating Lymphoma of Eye based on the assessment of the physician. [dovemed.com]
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Fever
Pt denied any associated fevers or chills. Physical exam revealed a right eyelid that was nearly swollen shut. However, patient had intact vision and extraocular movements in both eyes. [shmabstracts.com]
People with POS may also experience redness, tenderness, or inflammation of the eye, as well as fever and other signs of illness. [medicalnewstoday.com]
Case presentation Case one A 19-year-old Chinese female presented in Oct 2005 with fever, fatigue, cough and sputum. [bmcophthalmol.biomedcentral.com]
[…] lymphoma care at Mayo Clinic Types Symptoms Signs and symptoms of non-Hodgkin's lymphoma may include: Painless, swollen lymph nodes in your neck, armpits or groin Abdominal pain or swelling Chest pain, coughing or trouble breathing Persistent fatigue Fever [mayoclinic.org]
It is generally noted to be present with lymphoma affecting the central nervous system It can cause blurred vision, redness of the eyes, burning sensation, and other general signs and symptoms, such as fever, weight loss, and appetite loss. [dovemed.com]
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Fishing
FISH testing revealed MYC gene rearrangement, IGH-BCL2 translocation, and BCL6 gene rearrangement. There was no evidence of BCR/ABL1, PML/RARA or CBFB rearrangements. PET CT showed evidence of systemic lymphoma. [shmabstracts.com]
The test is ultrasensitive and detects extremely low amounts of biomarkers remaining in blood, which can be missed by cytogenetic methods, such as FISH, karyotype, or flow cytometry. [dovemed.com]
Fish flesh appearan 19. lymphoma Conjunctiva Lacrimal gland Tend to be more benign ,better long-term prognosis Those that extend into the orbit tend to be more malignant. [slideshare.net]
One colleague regularly plied me with Sichuan fish, a taste that survived chemo. Neighbors from our block helped with food and support, far more than my previous attention to the neighborhood warranted. [theatlantic.com]
More specific key signs for a conjunctival lymphoma include the presence of a fleshy, vascularized, salmon-colored/fish-flesh swollen patch that is freely mobile and usually unilateral. 2 While definitive diagnosis is made through conjunctival biopsy [journal.opted.org]
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Anemia
The signs and symptoms of Ocular Lymphoma may include: Burning sensation in the eye; watery eye Foreign body sensation in the eye Redness of the eyes Blurry vision Unintentional weight loss; changes in appetite Fatigue and weakness, headache Anemia (low [dovemed.com]
Toxicity related to MTX was modest, with only two episodes of grade 3 anemia, one episode of grade 3 neutropenia, and no treatment-related deaths. [clincancerres.aacrjournals.org]
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Chills
Pt denied any associated fevers or chills. Physical exam revealed a right eyelid that was nearly swollen shut. However, patient had intact vision and extraocular movements in both eyes. [shmabstracts.com]
Gastrointestinal
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Loss of Appetite
It is generally noted to be present with lymphoma affecting the central nervous system It can cause blurred vision, redness of the eyes, burning sensation, and other general signs and symptoms, such as fever, weight loss, and appetite loss. [dovemed.com]
Lymphoma may occur in any lymph node, but it usually affects those in the following areas: neck armpit groin abdomen Other symptoms include: loss of appetite unexplained weight loss pain in the abdomen indigestion and bloating nausea and vomiting abnormal [medicalnewstoday.com]
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Regurgitation
Case Presentation: 60 year old African American man with history of HTN, HLD, and mitral valve regurgitation presented to the ER complaining of 2.5 weeks of progressively worsening right eye pain and swelling. [shmabstracts.com]
Cardiovascular
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Tachycardia
The remainder of the exam was significant only for tachycardia and a 3/6 systolic murmur. Laboratory results were significant for a WBC of 33,000, Hgb 11.4, and MCV 101. ESR was 24 and CRP was 13.4. BMP and CBC were otherwise unremarkable. [shmabstracts.com]
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Systolic Murmur
The remainder of the exam was significant only for tachycardia and a 3/6 systolic murmur. Laboratory results were significant for a WBC of 33,000, Hgb 11.4, and MCV 101. ESR was 24 and CRP was 13.4. BMP and CBC were otherwise unremarkable. [shmabstracts.com]
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Heart Disease
disease Radiation can damage healthy cells in addition to cancer cells, causing further complications Supportive treatment: Steroids, blood transfusions, anti-nausea medications, and antibiotics, may be used as supportive therapy. [dovemed.com]
Skin
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Erythema
The persistence of symptoms, absence of pain, and lack of erythema and tenderness on exam should arouse suspicion for this masquerading malignancy. To cite this abstract: Gribben, WB; Katukoori, S. [shmabstracts.com]
The patient now had a marked worsening of the conjunctival erythema and chemosis. A biopsy was performed, revealing low-grade malignant mucosa-associated lymphoid tissue (MALT) lymphoma. [reviewofoptometry.com]
[…] superior lateral quadrant, in proximity to the lacrimal gland 1,6 : palpable mass exophthalmos ptosis diplopia and abnormal ocular movement Generally the mass is painless; however, a subset of patients demonstrate inflammatory-like changes, including pain, erythema [radiopaedia.org]
Extranodal oral lymphoma of soft tissue is typically a nontender, poorly circumscribed, compressible, soft tissue enlargement, sometimes with erythema and ulceration of the overlying mucosa." " "The data demonstrate that primary lymphoma involving the [lymphomation.org]
No changes in vision, eyelid edema or erythema, or other symptoms were noted. The patient had been followed closely after radiation treatment, and no evidence of disease recurrence had been seen by the time of this publication (Figure 2). Figure 1A. [journal.opted.org]
Eyes
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Eye Pain
Case Presentation: 60 year old African American man with history of HTN, HLD, and mitral valve regurgitation presented to the ER complaining of 2.5 weeks of progressively worsening right eye pain and swelling. [shmabstracts.com]
The most common symptoms for eye lymphoma include: blurry vision decrease or loss of vision floaters (seeing small dots or lines in your field of vision) redness or swelling in the eye being extra sensitive to light eye pain (though this is rare) Lymphoma [aao.org]
The most common symptoms for PIOL include: blurry vision decrease or loss of vision floaters (small dots or lines in the field of vision) redness or swelling in the eye increased sensitivity to light eye pain (rarely) While lymphoma usually affects both [columbiaeye.org]
Symptoms of eye cancer include bulging of the eye, some loss of sight, blurred vision, dark spot on the iris, flashing lights, shadows and misting of the eye lens, and eye pain. [cancer.ie]
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Photophobia
Patients may also complain of redness, tearing, itching, irritation, photophobia, proptosis, pain, ptosis and diplopia. [reviewofoptometry.com]
FEATURES Primary intraocular lymphoma generally masquerades as a chronic intermediate uveitis that is unresponsive to corticosteroids in older individuals (median age in the 60s).2,3,5 Common symptoms are blurred vision and floaters and, less commonly, photophobia [archivesofpathology.org]
[…] mediating cellular responses) Supporting the optical function of the cornea Tear secretion List differential diagnoses for a conjunctival mass While patients with a conjunctival mass can present with complaints of irritation, pain, discharge, epiphora and photophobia [journal.opted.org]
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Eye Swelling
Despite antibiotic treatment, the patient’s eye swelling began to increase. He developed worsening right eye pain and proptosis, with decreasing vision and rising intraocular pressure. [shmabstracts.com]
These symptoms may include: pink or redness in the whites of the eyes swelling of the conjunctiva or eyelid itching, burning, or irritation watery discharge from the eye an urge to rub the eye crusting of the eyelids or eyelashes, especially upon waking [medicalnewstoday.com]
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Foreign Body Sensation
The signs and symptoms of Ocular Lymphoma may include: Burning sensation in the eye; watery eye Foreign body sensation in the eye Redness of the eyes Blurry vision Unintentional weight loss; changes in appetite Fatigue and weakness, headache Anemia (low [dovemed.com]
Musculoskeletal
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Arthritis
People at risk for getting eye lymphoma include those who: have rheumatoid arthritis or other autoimmune diseases have certain medical problems that affect their immune system have AIDS (acquired immunodeficiency syndrome) are taking certain medications [aao.org]
Most people who develop PIOL are elderly or have immune system diseases such as rheumatoid arthritis, AIDS (acquired immunodeficiency syndrome), or are taking medications to prevent their bodies from rejecting a transplanted organ. [columbiaeye.org]
Those with rheumatoid arthritis or take anti-rejection drugs after a transplant are also at a higher risk for this disease. Genetics may also contribute and play a role in the development of ocular lymphoma. [myeyeassociates.com]
This includes people who: • Have rheumatoid arthritis or other autoimmune diseases; • Have rare medical conditions that affect their immune system; • Have AIDS (acquired immunodeficiency syndrome); • Are taking certain medications to prevent rejection [sflhealthandwellness.com]
[…] as toxocariasis, clinical findings and serum antibody titers are used more often for a diagnosis.23 Inflammatory etiologies include uveitis-glaucoma-hyphema syndrome, sympathetic ophthalmia, sarcoidosis, pars planitis, multiple sclerosis, rheumatoid arthritis [archivesofpathology.org]
Neurologic
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Dizziness
[…] serious complications from such infections Occasionally, the tumor can transform into a more aggressive form or subtype of lymphoma There may be complications related to chemotherapy used in treating the condition, which may include: Side effects such as dizziness [dovemed.com]
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Burning Sensation
It is generally noted to be present with lymphoma affecting the central nervous system It can cause blurred vision, redness of the eyes, burning sensation, and other general signs and symptoms, such as fever, weight loss, and appetite loss. [dovemed.com]
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Myelopathy
Complete imaging of the spinal cord is not necessary in every patient with primary CNS lymphoma, but patients with neck or back pain, and symptoms or signs suggestive of myelopathy should have an enhanced MR scan of the entire spine. [cancernetwork.com]
Workup
DIAGNOSIS PCNSL should be suspected in any patient with posterior uveitis who has a negative workup for common causes of posterior uveitis. [retinatoday.com]
Clinical awareness of any atypical ocular presentations in NKTCL cases should necessitate thorough workup in order not to hinder an early discovery of disease relapse. References Armitage JO: The aggressive peripheral T-cell lymphomas. [cureus.com]
CSF dissemination is detected during staging workup in only 10–15% of cases (Grimm et al, 2007 ). [onlinelibrary.wiley.com]
Treatment
The following are treatment options for lymphoma of the eye. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan. [cancer.ca]
He continues, "I hope that this treatment protocol would become the impetus for breaking down the poor prognosis of this disease." [u-tokyo.ac.jp]
Recurring tumors have worse prognosis compared to tumors that do not recur Response to treatment: Tumors that respond to treatment have better prognosis compared to tumors that do not respond to treatment Progression of the condition makes the outcome [dovemed.com]
of the San Raffaele H Scientific Institute in Milan, Italy, and colleagues examined whether doxycycline was an effective treatment for OAL. [sciencedaily.com]
This would suggest that topical interferon therapy is a useful form of palliative treatment, when standard systemic treatment is inappropriate. [eyecancercure.com]
Prognosis
Among eye diseases, intraocular lymphoma has the worst survival prognosis. [u-tokyo.ac.jp]
What is common to most of these reports is that, when the lymphoma is found in the brain, the prognosis is poor. [eyecancer.com]
Prognosis is less favourable. [radiopaedia.org]
Etiology
The patient was admitted to our clinic for etiologic study and treatment. [ncbi.nlm.nih.gov]
Pathogenesis Etiology The eye itself is not the site of the lymphoma. There may be enlargement on the bulbar surface of the glans nictitans. One or both of the eyes may be affected. [vetstream.com]
The possible infective etiology may explain the probable increase in the incidence of orbital lymphomas (see below) 3. Typically patients are between 50 and 70 years of age, with no recognized gender predilection 6. [radiopaedia.org]
(Etiology) Lymphocytes are a type of white blood cells that are responsible for providing immunity in the human body. B-cells and T-cells are the two different types of lymphocytes. [dovemed.com]
The differential diagnosis includes infectious, inflammatory, and other neoplastic processes.22 Infectious etiologies include endophthalmitis secondary to bacterial, viral, fungal, or parasitic infections.22 A vitreous sample is obtained and should be [archivesofpathology.org]
Epidemiology
Epidemiology Neoplasia of the eye and orbit is uncommon in ferrets. Malignant lymphoma is the most common neoplasm in both the eye and the orbit. [vetstream.com]
"Epidemiology of primary CNS lymphoma". Journal of Neuro-Oncology. 43 (3): 199–201. doi : 10.1023/A:1006290032052. PMID 10563423. Ahmed, S; Shahid, RK; Sison, CP; Fuchs, A; Mehrotra, B (February 2006). [en.wikipedia.org]
It provides a thorough review of conjunctival anatomy and physiology along with explanations of key findings, common clinical presentations, differential diagnoses, epidemiology, pathophysiology, risk factors, treatment and management options and prognosis [journal.opted.org]
PMID 28682481 Descriptive epidemiology of ophthalmic and ocular adnexal non-Hodgkin's lymphoma. Moslehi R, Coles FB, Schymura MJ Expert Rev Ophthalmol. 2011;6:175-180. [atlasgeneticsoncology.org]
Fisher SG, Fisher RI (2004) The epidemiology of non-Hodgkin's lymphoma. Oncogene 23: 6524-6534. Palackdharry CS (1994) The epidemiology of non-Hodgkin's lymphoma: Why the increased incidence? Oncology (Williston Park) 8: 67-73. [omicsonline.org]
Pathophysiology
A review of ocular lymphoma diagnosis, pathophysiology, and management is undertaken. Format: video Series: Moran Eye Center Grand Rounds Identifier: Moran_CORE_15769 Copyright statement: Copyright 2015. [morancore.utah.edu]
It provides a thorough review of conjunctival anatomy and physiology along with explanations of key findings, common clinical presentations, differential diagnoses, epidemiology, pathophysiology, risk factors, treatment and management options and prognosis [journal.opted.org]
Pathophysiology [ edit ] Recent studies [ by whom? ] have detected the presence of viral DNA in ocular lymphoma cells. This implies that pathogens play a role in ocular lymphoma. [en.wikipedia.org]
Pathophysiology of retinal lymphoma. Ocul Immunol Inflamm. 2009;17(4):227–237. 6. Char DH, Ljung BM, Deschênes J, Miller TR. Intraocular lymphoma: immunological and cytological analysis. Br J Ophthalmol. 1988;72(12):905–911. 7. [dovepress.com]
Prevention
This can help prevent cancer from spreading there or help destroy hidden cancer cells. [columbiaeye.org]
This finding shows that aggressive systemic chemotherapy and preventive radiotherapy could greatly improve the prognosis of the disease. "Intraocular malignant lymphoma, although a disease of the eye, is intractable and life-threatening. [u-tokyo.ac.jp]
[…] at risk for getting eye lymphoma include those who: have rheumatoid arthritis or other autoimmune diseases have certain medical problems that affect their immune system have AIDS (acquired immunodeficiency syndrome) are taking certain medications to prevent [aao.org]
Radiation therapy may also be directed to the brain and spinal cord to help prevent the cancer from spreading there or to help destroy undetected cancer cells that could be there. Lauren R. Rosecan M.D., Ph.D., F.A.C.S. [sflhealthandwellness.com]
It will help prevent the cancer from spreading or kill any cancer cells that may be there. Treatment depends on whether or not the cancer is in other parts of the body. [myeyeassociates.com]