多彩な眼症状を示した眼・中枢神経系悪性リンパ腫の1例

A case of intraocular-central nervous system lymphoma with multiple ocular manifestations

　67歳女性が3週前からの左眼視力低下で受診した。頭蓋内悪性リンパ腫の既往があり，6か月前に全脳の放射線照射を受けた。矯正視力は右1.0，左光覚弁で，左眼には硝子体混濁網膜中心静脈閉塞症様の出血，超音波検査で網膜剥離があった。眼科初診の2週間後に小脳に悪性リンパ腫の再発が発見されたが，眼内や視神経に腫瘍の浸潤はなかった。手術で得られた硝子体の細胞診で非ホジキンリンパ腫（non-Hodgkin lymphoma）と診断された。総量44Gyの放射線照射で病巣は鎮静化し，以後14か月間，光覚弁のまま左眼は安定している。多彩な眼内病変を呈した眼・中枢神経悪性リンパ腫の1例である。

A 67-year-old female prsented with blurring of visionin her left eye since 3 weeks before. She had been diagnosed with intracranial malignant lymphoma and had received radiation to the whole brain 6 months before. Her corrected visual acuity was 1.0 right and light perception left. The left eye showed vitreous opacity and retinal hemor-rhage simulating central retinal vein occlusion. Ultrasonography showed retinal detachment. Recurrence of malignant lymphoma was detected in the cerebellum 2 weeks later. There was no obvious infiltration of tumor in the optic nerve or in the eyeglobe. Vitreous specimen obtained during surgery led to the diagnosis of non-Hodgkin lymphoma. Exter-nal radiation totalling 44 Gy was followed by regression of ocular lesions during the ensuing 14 months. This case illus-trates that multiple intraocular lesions may develop in intraocular-central nervous system lymphoma.