Intraocular lymphoma: Difference between revisions

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*Patients with intraocular lymphoma usually appear pale or malnourished.  
*Patients with intraocular lymphoma usually appear pale or malnourished.  
*Physical examination may be remarkable for:
*Physical examination may be remarkable for:
:*[finding 1]
:*Irregular pupil
:*[finding 2]
:*[finding 3]
:*[finding 4]
:*[finding 5]
:*[finding 6]


=== Laboratory Findings ===
=== Laboratory Findings ===

Revision as of 20:29, 9 May 2016

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Articles on Intraocular lymphoma in N Eng J Med, Lancet, BMJ

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]

Synonyms and keywords: PIOL

Overview

Intraocular lymphoma (also known as "PIOL") is a rare subtype of primary central nervous system lymphoma. Intraocular lymphoma may affect the eye secondarily from a metastasis from a non-ocular tumor or may arise within the eye primarily. According to the World Health Organization (WHO) classification, intraocular lymphomas are most commonly a diffuse large B-cell immunohistologic subtype of non-Hodgkin's lymphoma. The most common symptoms of intraocular lymphoma is blurred or decreased vision. In the majority of patients, central nervous system involvement, only accounts for 20% of primary central nervous system lymphomas. The median age at diagnosis among patients with intraocular lymphoma is between 50-60 years. The pathogenesis of intraocular lymphoma is characterized by the affection of the sub-retinal pigment epithelium, which is normally involved in the light absorption. On fluorescein angiography, findings may reveal "leopard spot" patterns due to sub-retinal pigment epithelium infiltrates that stain early and progressively or mottling of the sub-retinal pigment epithelium due to hyper- and hypo-fluorescent window defects. The initial therapy for patients with intraocular lymphoma is corticosteroids.

Historical Perspective

  • Intraocular lymphoma was first discovered by [scientist name], a [nationality + occupation], in [year] during/following [event].

Classification

  • Intraocular lymphoma may be classified according to [classification method] into [number] subtypes/groups:
  • [group1]
  • [group2]
  • [group3]

Pathophysiology

  • The pathogenesis of intraocular lymphoma is characterized by
  • Genes associated with the development of intraocular lymphoma, include:
  • On gross pathology, characteristic findings of intraocular lymphoma, include:
  • On microscopic histopathological analysis, characteristic findings of intraocular lymphoma, include:
  • Atypical lymphocytes (gold standard)

Causes

  • Common causes of intraocular lymphoma, include:

Differentiating Intraocular Lymphoma from Other Diseases

  • Intraocular lymphoma must be differentiated from other diseases that cause chronic loss of vision, such as:
  • [Differential dx1]
  • [Differential dx2]
  • [Differential dx3]

Epidemiology and Demographics

  • The prevalence of intraocular lymphoma is approximately [number or range] per 100,000 individuals worldwide.
  • In [year], the incidence of intraocular lymphoma was estimated to be [number or range] cases per 100,000 individuals in [location].

Age

  • Patients of all age groups may develop intraocular lymphoma.
  • Intraocular lymphoma is more commonly observed among patients aged [age range] years old.
  • Intraocular lymphoma is more commonly observed among [elderly patients/young patients/children].

Gender

  • Intraocular lymphoma affects men and women equally.
  • [Gender 1] are more commonly affected with intraocular lymphoma than [gender 2].
  • The [gender 1] to [Gender 2] ratio is approximately [number > 1] to 1.

Race

  • There is no racial predilection for intraocular lymphoma.
  • Intraocular lymphoma usually affects individuals of the [race 1] race.
  • [Race 2] individuals are less likely to develop intraocular lymphoma.

Risk Factors

  • Common risk factors in the development of intraocular lymphoma, include:

Natural History, Complications and Prognosis

  • The majority of patients with intraocular lymphoma are symptomatic at the time of diagnosis.
  • Early clinical features include
  • If left untreated, patients with intraocular lymphoma may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
  • Common complications of intraocular lymphoma include [complication 1], [complication 2], and [complication 3].
  • Prognosis is generally good, and the median survival rate of patients with intraocular lymphoma is approximately

Diagnosis

Diagnostic Criteria

  • The diagnosis of intraocular lymphoma is made with the following diagnostic criteria:
  • [criterion 1]
  • [criterion 2]
  • [criterion 3]
  • [criterion 4]

Symptoms

  • Symptoms of intraocular lymphoma may include the following:
  • Burning of the eye
  • Redness of the eye
  • Blurred vision
  • Photophobia or sensitivity to light
  • Eye pain
  • Floaters (which are dark spots that float in the visual field)
  • Headache

Physical Examination

  • Patients with intraocular lymphoma usually appear pale or malnourished.
  • Physical examination may be remarkable for:
  • Irregular pupil

Laboratory Findings

  • There are no specific laboratory findings associated with intraocular lymphoma.

Imaging Findings

  • Magnetic resonance image (MRI) is the imaging modality of choice for patients with intraocular lymphoma.
  • On MRI, characteristic findings of intraocular lymphoma, include:

Treatment

Medical Therapy

  • There is no treatment for intraocular lymphoma; the mainstay of therapy is supportive care.
  • The mainstay of therapy for intraocular lymphoma is [medical therapy 1] and [medical therapy 2].
  • [Medical therapy 1] acts by [mechanism of action1].
  • Response to [medical therapy 1] can be monitored with [test/physical finding/imaging] every [frequency/duration].

Surgery

  • Surgery is the mainstay of therapy for intraocular lymphoma.
  • [Surgical procedure] in conjunction with [chemotherapy/radiation] is the most common approach to the treatment of intraocular lymphoma.
  • [Surgical procedure] can only be performed for patients with [disease stage] intraocular lymphoma.

Prevention

  • There are no primary preventive measures available for intraocular lymphoma.
  • Once diagnosed and successfully treated, patients with intraocular lymphoma are followed-up every [duration]. Follow-up testing includes [test 1], [test 2], and [test 3].

References