網膜下滲出斑の出現と自然消退を繰り返した眼内悪性リンパ腫の1例

Recurrent appearance and disappearance of subretinal infiltrates in a case of intraocular malignant lymphoma

　57歳男性が3週間前からの左眼飛蚊症で受診した。左眼の眼底後局部に網膜下滲出斑が十数個あつたが、2週間で自然消退した。以後6か月間に網膜下滲出斑は計6回，出現と消退を繰り返した。初診から6か月後に左眼に硝子体混濁が生じ，副腎皮質ステロイド薬で消退したが，さらに5か月後に両眼に硝子体混濁が生じた。硝子体試験切除を行い，細胞診で眼内悪性リンパ腫と診断された。両眼への硝子体切除術と放射線照射で寛解した。本症例は，眼内悪性リンパ腫が仮面症候群として眼底病巣があたかも炎症性疾患のように出現と自然消退を繰り返した稀な例である。

A 57-year-old man presented with seeing floaters in his left eye since 3 weeks before. Funduscopy showed numerous subretinal infiltrates in the central fundus area. They spontaneously disappeared 2 weeks later. During the ensuing 6 months, subretinal infiltrates appeared and disappeared six times. Six months after his initial visit, vitreous opacity developed in his left eye which subsided following systemic corticosteroids. Both eyes developed vitreous opacity another 5 months later. Vitreous biopsy led to the diagnosis of intraocular malignant lymphoma. Clinical cure was obtained following vitrectomy and radiation for both eyes. This case illustrates that intraocular malignant lymphoma may manifest recurrent subretinal infiltrates simulating ocular inflammation.