Conjunctival infiltration as a relapse of lymphoma

Abstract

Ocular involvement in patients with hematologic malignancies especially Non-Hodgkin Lymphoma (NHL) remains frequently unrecognized and in consequence not adequately treated. Ocular involvement in different subtypes of Non-Hodgkin’s lymphoma is more common than Hodgkin's lymphoma, including predominantly diffuse large B-cell lymphoma (DLBCL), mucosa-associated lymphoid tissue (MALT) lymphoma and T-cell lymphoma. In this report, we present a patient with marginal zone B cell lymphoma that was diagnosed and treated with R-CHOP. He had relapse after three years and treated with R-Bendamustine and again achieved complete remission. He presented with redness of eyes about 2 years later, on July 2017. At first he was treated for conjunctivitis, but subsequently orbital mass was reported in MRI which biopsy from his conjunctive showed low grade lymphoma infiltration in conjunctiva. He did not have response with chemotherapy R-Bendamustin, but he achieved complete response with radiotherapy. Hematologic malignancies with eye involvement may cause permanent damage of visual acuity and its timely recognition and treatment can prevent unnecessary visual loss.

Keywords: Ocular lymphoma, immune-privileged, extra-nodal relapse.

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