眼・中枢神経系悪性リンパ腫の1例

A case of malignant lymphoma in the eye and central nervous system

（B6-1-17）　56歳男性が数週前からの両眼の霧視で受診した。虹彩炎の所見と，硝子体混濁を伴う眼底の乳白色隆起性病変があり，検眼鏡的に原発または転移性脈絡膜腫瘍を疑った。頭部MRI検査で脳梁にガドリニウムが造影され，悪性リンパ腫が疑われた。両眼に硝子体手術を行い，細胞診から幼弱な腫瘍細胞が検出された。切除した硝子体のフローサイトメトリー法での細胞表面マーカー検索で，悪性リンパ腫の診断が確定した。手術後の放射線照射と化学療法で眼底病変は瘢痕治癒し，視力が回復した。

A 56-year-old male presented with bilateral blurring of vision of few weeks' duration. Both eyes showed signs of iridocyclitis, vitreous opacity and milky white protrusion in the fundus. The findings were suggestive of primary or metastatic choroidal tumor. Magnetic resonance imaging (MRI) of the brain showed Gd-enhanced mass in the corpus callosum typical for malignant lymphoma. Both eyes were treated by vitrectomy. Immature tumor cells were detected in the vitreous specimen. Another vitreous specimen was subjected to flow cytometry. Analysis of cell surface markers led to the definitive diagnosis of malignant lymphoma. Postoperative radiation and chemotherapy induced cicatriazation of fundus lesions and recovery of vision in both eyes.