IMMUNE RECOVERY UVEITIS-LIKE SYNDROME MIMICKING RECURRENT T-CELL LYMPHOMA AFTER AUTOLOGOUS BONE MARROW TRANSPLANT. Retin Cases Brief Rep 2021 Jul 01;15(4):407-411
Date
11/30/2018Pubmed ID
30489451DOI
10.1097/ICB.0000000000000829Scopus ID
2-s2.0-85071778920 (requires institutional sign-in at Scopus site) 2 CitationsAbstract
PURPOSE: To report the multimodal imaging findings of immune recovery uveitis mimicking recurrent T-cell lymphoma after autologous bone marrow transplant therapy.
METHODS: A 71-year-old man presented with posterior uveitis 6 weeks after chemotherapy and autologous bone marrow transplant for angioimmunoblastic T-cell lymphoma. Multimodal imaging included fluorescein angiography, fundus autofluorescence, and optical coherence tomography. Diagnostic testing included ocular polymerase chain reaction and diagnostic vitrectomy.
RESULTS: Clinical examination demonstrated vitritis and perivascular deep retinal whitening. Imaging of the retinal whitening showed late hyperfluorescence on fluorescein angiography, hyperautofluorescence on fundus autofluorescence, and ellipsoid zone loss on optical coherence tomography without infiltrative lesions. Testing was negative for syphilis, herpes simplex virus, varicella-zoster virus, and cytomegalovirus. After no clinical improvement with valacyclovir and intravitreal foscarnet treatment, diagnostic vitrectomy was performed. Bacterial and fungal cultures were negative, and herpes simplex virus, varicella-zoster virus, and cytomegalovirus were not detected by polymerase chain reaction. Cytopathology showed mature small nonneoplastic lymphocytes, macrophages, and monocytes. Flow cytometry demonstrated a reactive T-cell population. The patient demonstrated clinical improvement over time with spontaneous resolution of all retinal findings.
CONCLUSION: This case most likely represents immune recovery uveitis-like syndrome. Diagnostic vitrectomy is highly valuable when the differential includes inflammatory, infectious, and neoplastic processes.
Author List
Lavine JA, Singh AD, Baynes K, Srivastava SKAuthor
Keith E. Baynes MD Chief, Associate Professor in the Radiology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AgedAutografts
Bone Marrow Transplantation
Diagnosis, Differential
Fluorescein Angiography
Humans
Lymphoma, T-Cell
Male
Multimodal Imaging
Neoplasm Recurrence, Local
Uveitis, Posterior
