SIMULTANEOUS INTRAOCULAR AND ORBITAL NON-HODGKIN-LYMPHOMA IN THE ACQUIRED-IMMUNE-DEFICIENCY-SYNDROME

Background: Non-Hodgkin lymphoma is more common in patients with the a cquired immune deficiency syndrome (AIDS), and the incidence of non-Ho dgkin lymphoma in the AIDS population has been increasing as the life expectancy of these patients has increased. Nevertheless, intraocular lymphoma, as part of primary central nervous system lymphoma and orbit al non-Hodgkin lymphoma, has rarely been reported in patients with AID S. Coexistent intraocular and orbital lymphoma is exceptionally unusua l. The clinical and histopathologic findings are reported in a patient with AIDS who had simultaneous intraocular and orbital non-Hodgkin ly mphoma. The clinical funduscopic findings initially were attributed to a viral retinitis. Methods: A left orbital biopsy followed by enuclea tion of the left eye was performed and studied by light microscopy. Im munophenotyping of the orbital biopsy also was performed. Findings: Si multaneous intraocular and orbital large cell malignant lymphoma was p resent with neoplastic spread directly along the scleral canal of the ciliary nerve. Massive necrosis Involving the retina, retinal pigment epithelium, choroid, and optic nerve, as well as several solid retinal pigment epithelial detachments, were observed. Immunophenotyping of t he orbital tumor disclosed positive staining for Leu 4 (T cells, 30%) and Leu 14 (B cells, 60%). Immunostaining for light and heavy chains w as precluded by tumor necrosis. Conclusion: Non-Hodgkin lymphoma shoul d be included in the differential diagnosis of acute retinitis, and pr optosis in patients with AIDS.