CENTRAL-NERVOUS-SYSTEM MALIGNANT B-CELL LYMPHOMA IDENTIFIED WITH STANDARDIZED ECHOGRAPHY OF THE OPTIC-NERVE

Ocular-central nervous system malignant B-cell lymphoma initially caus ed diplopia and morning headaches in a 10-year-old boy. After initial diagnosis of pseudotumor cerebri was made, based on normal findings fr om magnetic resonance imaging and magnetic resonance angiography elsew here, he was treated with acetazolamide. Standardized echography demon strated a combination of solid infiltration and fluid within the optic nerve sheaths. Lumbar puncture showed elevated opening pressure and c erebrospinal diagnostic of central nervous system (CNS) B-cell lymphom a, which was confirmed by gene rearrangement. Results of peripheral bl ood study were negative. Aggressive treatment with chemotherapy and ex ternal-beam radiation produced complete resolution of solid optic nerv e sheath infiltration in both eyes. This report discusses the clinical and ultrasonographic characteristics of CNS malignant B-cell lymphoma with ocular involvement and its differentiation from pseudotumor cere bri.