Retinal artery obstruction and atheromas associated with non-Hodgkin's large cell lymphoma (reticulum cell sarcoma)
J. D. Gass and H. L. Trattler
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, School of Medicine 33101.
A 71-year-old woman developed branch retinal artery obstruction as the
presenting manifestation of a large cell non-Hodgkin's lymphoma. Multifocal
chorioretinal scars were present in the same eye. She experienced
progressive visual loss accompanied by development of multiple yellow
retinal arterial wall plaques, extension of retinal opacification into
other quadrants, and increasing vitreous cellular infiltration. Clinical
diagnoses included branch retinal arterial obstruction caused by
toxoplasmosis retinitis, multifocal choroiditis and panuveitis simulating
the presumed ocular histoplasmosis syndrome, vitiliginous chorioretinitis,
and the acute retinal necrosis syndrome. Four months after onset, the right
eye was blind and was enucleated. Histopathologic examination revealed
extensive lymphomatous infiltration and necrosis of the retina and optic
nerve. The retinal arteries were partly obstructed by lymphomatous
infiltration and atheromas. Subsequently, the left eye and central nervous
system were involved by lymphoma.
