Ocular Involvement in a Patient with Intravascular Large B-Cell Lymphoma: A Diagnostic Challenge. Clinical Case Report and Literature Review

Ocul Immunol Inflamm. 2023 Feb 6:1-8. doi: 10.1080/09273948.2022.2103712. Online ahead of print.

Abstract

Purpose: To describe the ophthalmic findings and diagnosis of a case of intravascular large B-cell lymphoma.

Methods: Clinical case observational report.

Clinical case: A Spanish 51-year-old man referred to our hospital with a diagnosis of panuveitis. The patient presented with blurred vision, photophobia, fever, and weight loss. Ocular examination revealed anterior uveitis, vitritis, and multiple round and oval creamy spots on the posterior pole. Fluorescein angiography, optical coherence tomography (OCT), and angio-OCT were used for the ocular examination. The diagnosis of lymphoma was formulated on the basis of a random normal skin biopsy, which showed significant CD20 cellularity within the vessels and extensive CD3 expression.

Conclusions: Intravascular lymphoma is a rare form of extranodal diffuse large B-cell lymphoma, often with delayed diagnosis because of the nonspecific symptoms. Hence, random skin biopsy could be useful in the diagnosis.

Keywords: Choroidal ischemia; intravascular large B-cell lymphoma; masquerade syndrome; ocular lymphoma; uveitis.