First Author: A.Serrano Peluffo COLOMBIA
Co Author(s): V. Llorens A. Adan
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To describe the cases of intraocular lymphomas seen in our uveitis department, classifying them in primary intraocular lymphomas (PIOL) and secondary intraocular lymphomas (SIOL) and looking the evolution of these and its prognosis.
Primary intraocular lymphoma. Secondary intraocular lymphoma
Descriptive study about intraocular lymphomas seen in the Department of Uveitis of Hospital Clínic de Barcelona with a follow-up period between 7 months and 7 years. We excluded the cases of lymphomas with only conjunctival or palpebral affection and the other primary or secondary intraocular solid tumours that were not lymphomas.
A total of 17 cases (8 bilateral) were analyzed. The group of SIOL had a slightly higher prevalence (53% of cases), being the mucosa-associated lymphoid tissue (MALT, 4 cases and all by contiguity) and Diffuse Large B-Cell Lymphoma (DLBCL) the most frequent equally, and the remaining case a nasal type natural killer/T-cell lymphoma. Of cases with MALT lymphoma no deaths were documented at 6-year follow-up, while in cases with DLBCL deaths were recorded in 75% within 4 years follow-up (Including 1 case of paranasal sinuses involvement). The patient with nasal type natural killer/T-cell lymphoma died at 12 months follow-up. Of the PIOL, death was documented in 88% of cases within 6 years of follow-up. In 76.5% of cases primary or secondary intraocular lymphoma was diagnosed within the first 6 months of onset of ophthalmologic symptoms and 88% in the first year. All patients received systemic chemotherapy, 5 patients with PIOL received holocranial radiotherapy, and half of the cases with SIOL-type DLBCL received bone marrow transplantation. About the 5-year survival rate from the diagnosis of intraocular lymphoma in the PIOL group was 37.5%; in the SIOL group, the MALT lymphoma with 100% and the DLBCL with 25%.
Our findings confirm the poor prognosis and the great malign potential of PIOL, which is in accordance with published literature. About SIOL, those by contiguity, MALT lymphoma type showed a good prognosis, whereas the case of DLBCL with paranasal sinus involvement showed a poor outcome; SIOL secondary to hematogenous dissemination (the great majority of DLBCL) showed a poor prognosis. For this reason the importance of the early diagnosis of this pathology and the optimal therapy.