Intraocular Lymphoma: Update on Diagnosis and Management

Overview

Journal Cancer Control

Specialty Oncology

Date 2004 Sep 21

PMID 15377987

Citations 55

Authors

Chi-Chao Chan

Dana J Wallace

Affiliations

Soon will be listed here.

Abstract

Background: Primary intraocular lymphoma (PIOL) is a subset of primary central nervous system lymphoma (PCNSL) in which lymphoma cells initially invade the retina, vitreous, or optic nerve head, with or without concomitant CNS involvement. The incidence of this previously rare condition has increased dramatically. Given its nonspecific presentation and aggressive course, PIOL provides a diagnostic and therapeutic challenge.

Methods: We review the current strategies for diagnosis and treatment of PIOL and present our own experience with PIOL.

Results: Recent developments in the diagnosis of PIOL include immunohistochemistry, flow cytometry, cytokine evaluation, and molecular analysis. However, definitive diagnosis still requires harvesting of tissue for histopathology. Optimal treatment for PIOL remains unclear. Initial therapeutic regimens should include methotrexate-based chemotherapy and radiotherapy to the brain and eye. In addition, promising results have been seen with intravitreal methotrexate and autologous stem cell transplantation for recurrent and refractory disease.

Conclusions: Efforts to further determine the immunophenotype and molecular characteristics of PIOL will continue to assist in the diagnosis of PIOL. Future studies are required to determine the role of radiotherapy and optimal local and systemic chemotherapeutic regimens.

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References

Blumenkranz M, Ward T, Murphy S, MIELER W, Williams G, Long J . Applications and limitations of vitreoretinal biopsy techniques in intraocular large cell lymphoma. Retina. 1992; 12(3 Suppl):S64-70. DOI: 10.1097/00006982-199212031-00014. View

Gill M, Jampol L . Variations in the presentation of primary intraocular lymphoma: case reports and a review. Surv Ophthalmol. 2001; 45(6):463-71. DOI: 10.1016/s0039-6257(01)00217-x. View

Barrans S, Evans P, OConnor S, Kendall S, Owen R, Haynes A . The t(14;18) is associated with germinal center-derived diffuse large B-cell lymphoma and is a strong predictor of outcome. Clin Cancer Res. 2003; 9(6):2133-9. View

Cassoux N, Merle-Beral H, LeHoang P, Herbort C, Chan C . Interleukin-10 and intraocular-central nervous system lymphoma. Ophthalmology. 2001; 108(3):426-7. DOI: 10.1016/s0161-6420(00)00401-2. View

Nasir S, DeAngelis L . Update on the management of primary CNS lymphoma. Oncology (Williston Park). 2000; 14(2):228-34; discussion 237-42, 244. View

Tuaillon N, Chan C . Molecular analysis of primary central nervous system and primary intraocular lymphomas. Curr Mol Med. 2002; 1(2):259-72. DOI: 10.2174/1566524013363915. View

Peterson K, Gordon K, Heinemann M, DeAngelis L . The clinical spectrum of ocular lymphoma. Cancer. 1993; 72(3):843-9. DOI: 10.1002/1097-0142(19930801)72:3<843::aid-cncr2820720333>3.0.co;2-#. View

Lobo A, Lightman S . Vitreous aspiration needle tap in the diagnosis of intraocular inflammation. Ophthalmology. 2003; 110(3):595-9. DOI: 10.1016/S0161-6420(02)01895-X. View

Akpek E, Ahmed I, Hochberg F, Soheilian M, Dryja T, Jakobiec F . Intraocular-central nervous system lymphoma: clinical features, diagnosis, and outcomes. Ophthalmology. 1999; 106(9):1805-10. DOI: 10.1016/S0161-6420(99)90341-X. View

10.

Siegel M, Dalton J, Friedman A, Strauchen J, Watson C . Ten-year experience with primary ocular 'reticulum cell sarcoma' (large cell non-Hodgkin's lymphoma). Br J Ophthalmol. 1989; 73(5):342-6. PMC: 1041736. DOI: 10.1136/bjo.73.5.342. View

11.

Char D, Ljung B, Miller T, Phillips T . Primary intraocular lymphoma (ocular reticulum cell sarcoma) diagnosis and management. Ophthalmology. 1988; 95(5):625-30. DOI: 10.1016/s0161-6420(88)33145-3. View

12.

Schabet M . Epidemiology of primary CNS lymphoma. J Neurooncol. 1999; 43(3):199-201. DOI: 10.1023/a:1006290032052. View

13.

Buggage R, Velez G, Myers-Powell B, Shen D, Whitcup S, Chan C . Primary intraocular lymphoma with a low interleukin 10 to interleukin 6 ratio and heterogeneous IgH gene rearrangement. Arch Ophthalmol. 1999; 117(9):1239-42. DOI: 10.1001/archopht.117.9.1239. View

14.

DeAngelis L . Brain tumors. N Engl J Med. 2001; 344(2):114-23. DOI: 10.1056/NEJM200101113440207. View

15.

Volcker H, Naumann G . 'Primary' reticulum cell sarcoma of the retina. Dev Ophthalmol. 1981; 2:114-20. DOI: 10.1159/000395312. View

16.

Soussain C, Merle-Beral H, Reux I, Sutton L, Fardeau C, Gerber S . A single-center study of 11 patients with intraocular lymphoma treated with conventional chemotherapy followed by high-dose chemotherapy and autologous bone marrow transplantation in 5 cases. Leuk Lymphoma. 1996; 23(3-4):339-45. DOI: 10.3109/10428199609054837. View

17.

Cassoux N, Merle-Beral H, Leblond V, Bodaghi B, Milea D, Gerber S . Ocular and central nervous system lymphoma: clinical features and diagnosis. Ocul Immunol Inflamm. 2001; 8(4):243-50. DOI: 10.1076/ocii.8.4.243.6463. View

18.

Maloney D . Rituximab for follicular lymphoma. Curr Hematol Rep. 2003; 2(1):13-22. View

19.

DeAngelis L, Yahalom J, Thaler H, Kher U . Combined modality therapy for primary CNS lymphoma. J Clin Oncol. 1992; 10(4):635-43. DOI: 10.1200/JCO.1992.10.4.635. View

20.

Wolf L, Reed G, Buggage R, Nussenblatt R, Chan C . Vitreous cytokine levels. Ophthalmology. 2003; 110(8):1671-2. DOI: 10.1016/S0161-6420(03)00811-X. View