Korean J Ophthalmol.  2012 Feb;26(1):54-57. 10.3341/kjo.2012.26.1.54.

Intraocular Involvement of a Nasal Natural Killer T-Cell Lymphoma: A Case Report

• Yoo JH
• Kim SY
• Jung KB
• Lee JJ
• Lee SJ

• KMID: 1120183
• DOI: http://doi.org/10.3341/kjo.2012.26.1.54

Abstract

Herein, we report a case of nasal natural killer T-cell lymphoma (NKTL) with intraocular involvement. A 57-year-old woman was referred due to a three-day history of photophobia and diplopia in the left eye. One-month previously, she was diagnosed with nasal NKTL of the right nasal cavity. Ophthalmic examination revealed conjunctival injection and ptosis. The left pupil was fully dilated and non-reactive to light. Ocular motion was restricted on left-upper gaze. Five days later, anterior uveitis developed and persisted despite topical steroid treatment. An orbital magnetic resonance imaging was without specific findings, however, ophthalmoplegia, vitreous opacity, and an iris mass were observed. A diagnostic anterior chamber aspiration was performed. Aqueous humor aspiration revealed 35% morphologically atypical lymphocytes. After an intravitreal triamcinolone injection, radiotherapy and chemotherapy were administered; this resolved the uveitis and iris mass. When refractory uveitis or orbital pseudotumor occurs in patients with nasal NKTL, ocular and orbital involvement of the NKTL should be considered.

Keyword

Extranodal NK-T-cell lymphoma

MeSH Terms

Diagnosis, Differential
Eye Neoplasms/diagnosis/*secondary/therapy
Fatal Outcome
Female
Humans
Lymphoma, T-Cell/*pathology
Magnetic Resonance Imaging
Middle Aged
Natural Killer T-Cells/*pathology
Nose Neoplasms/*pathology

Figure

• 

  Fig. 1 (A) Fundoscopy revealed vitreous haziness and opacity. (B) Slit lamp exam revealed a nodular, depigmented, mass-like appearance of the iris (black arrow) and a pinkish lump in the iris (white arrow).

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  Fig. 2 (A) This photograph demonstrates multiple erythematous and violaceous, well-defined, coin-sized plaques and nodules in the lower limbs. (B) The neoplastic infiltrate was composed of small- to medium-sized pleomorphic lymphocytes with irregular nuclei, inconspicuous nucleoli, and scant cytoplasm. (C) Immunotype was CD56+. (D) Immunotype was CD3+.

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  Fig. 3 (A) Vitreous opacity resolved after radiotherapy at 900 cGy. (B) The iris masses resolved after radiotherapy at 900 cGy.

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