Bilateral optic neuropathy as the presenting sign of systemic non-Hodgkin lymphoma

Détails

ID Serval
serval:BIB_B366E64329CD
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Etude de cas (case report): rapporte une observation et la commente brièvement.
Collection
Publications
Titre
Bilateral optic neuropathy as the presenting sign of systemic non-Hodgkin lymphoma
Périodique
Klinische Monatsblatter fur Augenheilkunde
Auteur(s)
Henchoz  L., Borruat  F. X., Gonin  J., Zografos  L.
ISSN
0023-2165 (Print)
Statut éditorial
Publié
Date de publication
03/2003
Volume
220
Numéro
3
Pages
189-92
Notes
Case Reports
Journal Article --- Old month value: Mar
Résumé
BACKGROUND: Neuro-ophthalmological complications of lymphoma are numerous and occur mostly in the setting of a known lymphoma or as the sign of a recurrence. We report the case of a woman who presented a simultaneous bilateral optic neuropathy as the initial clinical manifestation of a non-Hodgkin malignant lymphoma. HISTORY AND SIGNS: An 87-year-old patient presented simultaneous bilateral visual acuity loss, dyschromatopsia, visual field defects and frontal headaches. Pallid disc swelling was present in both eyes with peripapillary hemorrhages. Bilateral anterior ischemic optic neuropathy was diagnosed, and giant cell arteritis was suspected. Temporal artery biopsy was negative. Marked visual improvement occurred after 24 hours of intraveinous methylprednisolone therapy, and vision completely recovered within a week. THERAPY AND OUTCOME: Four months later, vision deteriorated again with bilateral pallid disc swelling. Blood studies revealed hyperleucocytosis (56 G/L) with 94 % lymphocytes. General investigations revealed a low-grade non-Hodgkin disseminated lymphoma. CONCLUSIONS: Bilateral steroid-responsive anterior optic neuropathy can be the initial manifestation of systemic lymphoma, but this case illustrates the diagnostic dilemma of some anterior optic neuropathies.
Mots-clé
Aged Diagnosis, Differential Female Fluorescein Angiography Functional Laterality Humans Lymphoma, B-Cell/*diagnosis Lymphoma, Low-Grade/*diagnosis Magnetic Resonance Imaging Optic Nerve/pathology Optic Nerve Diseases/diagnosis/*etiology Paraneoplastic Syndromes/diagnosis/*etiology Vision Tests Visual Fields/physiology
Pubmed
Web of science
Création de la notice
28/01/2008 12:37
Dernière modification de la notice
20/08/2019 15:21
Données d'usage