悪性リンパ腫の寛解期に生じた浸潤性視神経症

Infiltrative optic neuropathy in a case of malignant lymphoma during remission

（17-G402-11）　70歳男性の右眼に視力低下が突発した。3年8か月前に非Hodgkinリンパ腫と診断され，化学療法と放射線治療で完全寛解の状態にあった。右眼矯正視力は0.08であり，乳頭が発赤腫脹していた。浸潤性視神経症と診断し，全身ステロイド剤投与と視神経部への放射線照射を行い，4週後に視力は0.8に回復した。3週後に視力が再び0.01に低下し，乳頭浮腫が再発した。放射線照射を行ったが，最終視力は0.1であった。悪性リンパ腫では寛解期でも浸潤性視神経症が起こりうることと，再発が多いことを示す症例である。

A 70-year-old male developed sudden visual impairment in his right eye. He had been diagnosed as non-Hodgkin lymphoma 3 years 8 months before. He was in a state of complete remission following systemic corticosteroid and radiation. The corrected visual acuity in the affected eye was 0.08. The optic disc was hyperemic and was swollen. We diagnosed the condition as infiltrative optic neuropathy. Systemic corticosteroid and radiation to the optic nerve resulted in improvement in visual acuity to 0.8 4 weeks later. The visual acuity decreased to 0.01 3 weeks later associated with recurrence of disc swelling. The final visual acuity remained at 0.1 in spite of radiation treatment. This case illustrates that infilatrative optic neuropathy may occur during the remission of malignant lymphoma with a tendency to recurrence.