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要約 目的:前部ぶどう膜炎を初発症状としたNK/T細胞リンパ腫の症例の報告。症例:58歳男性が4週間前からの右眼視力低下で受診した。気管支喘息と高血圧の既往があった。所見:矯正視力は右0.15,左0.3であり,右眼に虹彩炎の所見と虹彩腫瘤があった。左眼には陳旧化した網膜静脈分枝閉塞症の所見があった。プレドニゾロン内服は無効で,出血性前房蓄膿が起こり,初診1か月後に眼瞼下垂を伴う右眼上眼瞼に腫瘤が生じた。磁気共鳴画像検査(MRI)で篩骨洞と鼻腔に進展する腫瘍があった。生検でNK/T細胞リンパ腫の診断が確定した。骨髄穿刺でⅣ期とされ,SMILE療法を開始した。放射線照射を追加し,病変部は縮小したが,全身状態が悪化し初診から8か月後に不帰の転帰をとった。結論:NK/T細胞リンパ腫は予後不良であり,早期の診断と治療が望まれることを示す症例である。
Abstract. Purpose:To report a case of NT/T-cell lymphoma with anterior uveitis as the initial manifestation. Case:A 58-year-old male presented with impaired visual acuity in the right eye since 4 weeks before. He had had bronchial asthma and systemic hypertension. Findings:Corrected visual acuity was 0.15 right and 0.3 left. The right eye showed an iris tumor with signs of iritis. The left eye showed long-standing branch retinal vein occlusion. Systemic prednisolone was not effective and was followed by hemorrhagic hypopyon. The right upper eyelid showed a tumor with blepharoptosis. Magnetic resonance imaging(MRI)showed a tumor involving the ethmoid and maxillary sinus. Biopsy led to the diagnosis of NT/T-cell lymphoma. It was in stage Ⅳ after bone marrow biopsy. The lesions decreased in size after start of SMILE therapy and radiation. The patient died of emancipation 8 months after his initial visit. Conclusion:This case illustrates that NT/T-cell lymphoma may result in poor outcome and that early diagnosis with treatment is needed.
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