Human T-cell lymphotropic virus type I-associated retinal lymphoma. A clinicopathologic report
S. R. Kumar, P. S. Gill, D. G. Wagner, P. U. Dugel, T. Moudgil and N. A. Rao
Doheny Eye Institute, University of Southern California School of Medicine, Los Angeles.
Human T-cell lymphotropic virus type I has been associated with a wide
range of ocular conditions, including neoplastic, infectious, and
inflammatory lesions. We studied a patient infected with human T-cell
lymphotrophic virus type I who presented with deep retinal and subretinal
infiltrates but without cells in the vitreous. The differential diagnosis
included intraocular lymphoma and fungus infection. A chorioretinal biopsy
specimen obtained for tissue diagnosis disclosed large atypical mononuclear
cells located primarily at the level of the retinal pigment epithelium but
focally involving overlying retina. Electron microscopy of this infiltrate
showed features consistent with adult T-cell lymphoma/leukemia. Infection
by human T-cell lymphotropic virus type I was verified by polymerase chain
reaction studies conducted on peripheral-blood mononuclear cells. This case
emphasizes the occurrence of intraocular lesions in adult T-cell
lymphoma/leukemia that clinically show some features similar to those of
the usual ocular lymphoma (reticulum cell sarcoma); diagnosis can be
established by chorioretinal biopsy, thereby allowing appropriate therapy.
