Vitreoretinal lymphoma occurring after systemic chemotherapy for primary conjunctival diffuse large B cell lymphoma: A case report

Medicine (Baltimore). 2021 Oct 1;100(39):e27347. doi: 10.1097/MD.0000000000027347.

Abstract

Introduction: Ocular adnexal lymphoma and vitreoretinal lymphoma are rare forms of non-Hodgkin lymphoma. They are regarded as distinct disease entities due to the differences in molecular mechanism, management, and outcome. We present a rare case of conjunctival diffuse large B cell lymphoma (DLBCL) that developed to vitreoretinal lymphoma after systemic chemotherapy.

Patient concerns: A 60-year-old man presented with a left salmon-colored conjunctival mass.

Diagnosis: A biopsy was performed, and histopathologic examination showed DLBCL. Immunohistochemical staining was positive for CD20 with increased κ to λ light chain ratio.

Interventions: Bone marrow biopsy also revealed DLBCL. Gallium-67 scintigraphy showed abnormal uptake only in the left orbital lesion. Ann Arbor stage was estimated as IV. The patient underwent systemic combination chemotherapy and immunotherapy.

Outcomes: Four months after the last course of chemotherapy, primary conjunctival DLBCL relapsed, manifesting vitreous opacity. Diagnostic vitrectomy confirmed a diagnosis of vitreoretinal lymphoma.

Lessons: Conjunctival DLBCL and vitreoretinal lymphoma are both DLBCL. After systemic chemotherapy for conjunctival DLBCL, the lymphoma may relapse in intraocular sites as secondary vitreoretinal lymphoma.

Publication types

  • Case Reports

MeSH terms

  • Conjunctival Neoplasms / secondary*
  • Conjunctival Neoplasms / therapy
  • Humans
  • Intraocular Lymphoma / secondary*
  • Intraocular Lymphoma / therapy
  • Lymphoma, Large B-Cell, Diffuse / pathology*
  • Lymphoma, Large B-Cell, Diffuse / therapy
  • Male
  • Middle Aged
  • Retinal Neoplasms / secondary*
  • Retinal Neoplasms / therapy
  • Vitreous Body / pathology