Primary intraocular lymphoma with a low interleukin 10 to interleukin 6 ratio and heterogeneous IgH gene rearrangement

Primary intraocular lymphoma is almost always a central nervous system B-ce ll nonHodgkin lymphoma. Primary intraocular lymphoma is commonly diagnosed by demonstrating lymphoma cells in the vitreous or cerebrospinal fluid. An interleukin (IL) 10 to IL-6 ratio greater than 1.0 in these fluids and the detection of immunoglobulin gene rearrangement are useful adjuncts in the d iagnosis of primary intraocular lymphoma. We report a case of primary intra ocular lymphoma diagnosed by chorioretinal biopsy in which no malignant cel ls were identified in the vitreous and in which the IL-10 to IL-6 ratio was less than 1.0. The detection of IgH gene rearrangement heterogeneity in th e tumor cells by polymerase chain reaction, a high tumor mitotic figure rat e, and the rapid onset of multiple brain lesions suggest an aggressive mali gnant neoplasm.