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Arch Ophthalmol. 1999;117:1239-1242.

Primary intraocular lymphoma is almost always a central nervous system B-cell non–Hodgkin lymphoma. Primary intraocular lymphoma is commonly diagnosed by demonstrating lymphoma cells in the vitreous or cerebrospinal fluid. An interleukin (IL) 10 to IL-6 ratio greater than 1.0 in these fluids and the detection of immunoglobulin gene rearrangement are useful adjuncts in the diagnosis of primary intraocular lymphoma. We report a case of primary intraocular lymphoma diagnosed by chorioretinal biopsy in which no malignant cells were identified in the vitreous and in which the IL-10 to IL-6 ratio was less than 1.0. The detection of IgH gene rearrangement heterogeneity in the tumor cells by polymerase chain reaction, a high tumor mitotic figure rate, and the rapid onset of multiple brain lesions suggest an aggressive malignant neoplasm.

Ronald R. Buggage, MD; Gisela Velez, MD, MPH; Brenda Myers-Powell, MD, PhD; DeFen Shen, PhD; Scott M. Whitcup, MD; Chi-Chao Chan, MD
From the Laboratory of Immunology and the Clinical Branch, National Eye Institute, National Institutes of Health, Bethesda, Md.

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