過去4年間の眼内悪性リンパ腫の検討

A four-year review of intraocular malignant lymphoma

要約　過去4年間に眼内悪性リンパ腫5例9眼を経験した。男性1例，女性4例で，年齢は59～81歳，平均70歳であった。受診の動機は，視力低下3例，霧視1例，飛蚊症1例であった。初診時の全身検査で，眼外に悪性リンパ腫の所見は5例すべてになかった。全例に遷延する硝子体混濁があった。全例に硝子体生検を行い，細胞診で診断が確定した。硝子体中のIL-10/IL-6比が，測定した4例すべてで高値であった。しかし，この値と以後の経過には明らかな関連はなかった。診断後4例に全眼球照射を行い，うち3例には化学療法を行った。4例で，眼症状出現から4～48か月，平均23か月後に頭蓋内転移が起こった。これら4例は不幸な転帰をとった。

Abstract.　We observed intraocular malignant lymphoma in 9 eyes of 5 patients during the past 4 years. The series comprised one male and four females. Their ages ranged from 59 to 81 years,average 70 years. The presenting symptoms were impaired vision 3 cases,blurring 1 case,and seeing flies 1 case. Extraocular malignant lymphoma was ruled out in all the cases after their initial visit. Persistent vitreous opacity was present as a common feature in the 5 cases. Intraocular malignant lymphoma was diagnosed by vitreous biopsy. The ratio of interleukin（IL）-10 to IL-6 was elevated in 4 examined cases. This ratio had no relevance to later clinical course. Four cases received whole eye irradiation,three of which received additional chemotherapy. Intracranial involvement developed in 4 cases 4 to 48 months,average 23 months,after onset of eye symptoms. These 4 cases resulted in fatal outcome.