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要約 目的:頭蓋内悪性リンパ腫に両側の乳頭浮腫が併発した症例の報告。症例:63歳男性が12日前からの霧視で受診した。1年前に前立腺癌に対して前立腺全摘出を受けていた。10日前にMRI検査で前頭葉に1cm大の腫瘤が発見された。所見:矯正視力は左右とも0.2で,両眼に乳頭の発赤と浮腫があった。前房に炎症所見はなく,脳脊髄液の圧亢進はなかった。診断的治療としてステロイドパルス療法を行い,4日後には視力が右0.3,左0.6に改善し,1か月後には右0.4,左1.0になった。腫瘤が増大し,3か月後に腫瘤を亜全摘した。びまん性B細胞リンパ腫の診断が確定した。結論:本症例では眼内悪性リンパ腫の可能性が大きいが,乳頭浮腫型の原田病を鑑別する必要がある。
Abstract. Purpose:To report a case of intracranial malignant lymphoma who manifested bilateral disc edema. Case:A 63-year-old male presented with blurring in both eyes since 12 days before. He had received total resection of prostate cancer one year before. He had been diagnosed with a tumor of 10mm in diameter in the anterior lobe 10 days before. Findings:Corrected visual acuity was 0.2 in either eye. Both eyes showed swelling and hyperemia of optic disc. He was treated by pulsed corticosteroid. Visual acuity improved to 0.3 right and 0.6 left 4 days later. It improved to 0.4 right and 1.0 left one month later. The cerebral tumor enlarged and was removed 3 months later. It was diagnosed with diffuse large B cell lymphoma. Conclusion:This case was probably intraocular malignant lymphoma, which required exclusion of Vogt-Koyanagi-Harada disease.
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