化学療法が奏効した悪性リンパ腫による視神経浸潤

Chemotherapy was effective in a case with optic nerve involvement by malignant lymphoma

　61歳男性の両眼に悪性リンパ腫による視神経浸潤が発症した。化学療法により眼底所見は著明に改善したが，全身状態悪化により6ヵ月後死亡した。剖検により全身リンパ節，肝臓，脾臓，消化管，中枢神経系ではくも膜下腔，硬膜への浸潤が認められ，両眼の眼窩内視神経への浸潤が確認された。

A 61-year-old male presented with bilateral blurring of vision. He had been diagnosed as B-cell type malignant lymphoma 2 years before. He had gone through several courses of systemic chemo-therapy because of widespread lymph node involve-ments and multiple tumors in the alimentary tract.He manifested, ophthalmoscopically, findings simulating papillitis. The visual field was irregular-ly affected bilaterally. These findings suggested bilateral involvement of the optic nerve by malig-nant lymphoma. The ocular lesions prompted re-sponded to systemic chemotherapy. He died of respiratory failure 5 months after first visiting us.Postmortem studies revealed extension of malig-nant lymphoma to bilateral optic nerves in addition to lymph nodes, liver, spleen, alimentary tract, dura mater and the subarachnoid space.