Pseudo-inflammatory manifestations of choroidal lymphoma resembling Vogt-Koyanagi-Harada disease : case report based on multimodal imaging

Fukutsu, Kanae; Namba, Kenichi; Iwata, Daiju; Mizuuchi, Kazuomi; Kase, Satoru; Suzuki, Kayo; Shimizu, Hiroshi; Shibata, Yukiko; Yamawaki, Fumihiko; Onozawa, Masahiro; Ishida, Susumu

Pseudo-inflammatory manifestations of choroidal lymphoma resembling Vogt-Koyanagi-Harada disease : case report based on multimodal imaging

Fukutsu, Kanae; Namba, Kenichi; Iwata, Daiju et al.

BMC ophthalmology, 2020, 20(1), 94

Permalink : https://hdl.handle.net/2115/77820

このアイテムのアクセス数:616件（2026-08-26 07:12 集計）

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アクセス権	open access
URI	https://hdl.handle.net/2115/77820
タイトル	Pseudo-inflammatory manifestations of choroidal lymphoma resembling Vogt-Koyanagi-Harada disease : case report based on multimodal imaging
著者	Fukutsu, Kanae ; Namba, Kenichi ; Iwata, Daiju ; Mizuuchi, Kazuomi ; Kase, Satoru ; Suzuki, Kayo ; Shimizu, Hiroshi ; Shibata, Yukiko ; Yamawaki, Fumihiko ; Onozawa, Masahiro ; Ishida, Susumu
著者名 Fukutsu, Kanae
e-Rad_Researcher 70333599 著者名 Namba, Kenichi
e-Rad_Researcher 70374402 著者名 Iwata, Daiju
e-Rad_Researcher 80598780 著者名 Mizuuchi, Kazuomi
e-Rad_Researcher 60374394 著者名 Kase, Satoru
著者名 Suzuki, Kayo
著者名 Shimizu, Hiroshi
著者名 Shibata, Yukiko
著者名 Yamawaki, Fumihiko
e-Rad_Researcher 70455632 著者名 Onozawa, Masahiro
e-Rad_Researcher 10245558 著者名 Ishida, Susumu
言語	英語
キーワード	Choroidal lymphoma
	Indocyanine green angiography
	Laser speckle flowgraphy
	Serous retinal detachment
	Vogt-Koyanagi-Harada disease
発行日	2020-03-10
出版者	BioMed Central
収録物名	BMC ophthalmology
巻(号)	20(1)
ページ	94
抄録	Background Hematologic malignancies occasionally cause serous retinal detachment (SRD); however, its pathogenesis remains unclear. Here we present the imaging characteristics of metastatic choroidal lymphoma masquerading as Vogt-Koyanagi-Harada (VKH) disease. Case presentation A 45-year-old Japanese woman was referred to our clinic because of bilateral SRD with blurred vision. Fluorescein angiography revealed multiple pinpoint leakage followed by pooling OU. Enhanced depth imaging optical coherence tomography showed marked choroidal thickening OU. Laser speckle flowgraphy detected choroidal circulation impairment OU. Although these results totally agreed with the inflammatory manifestations of acute VKH disease, indocyanine green angiography demonstrated various sizes of sharply marginated hypofluorescent lesions that seemed atypical for the finding of VKH disease, i.e., vaguely marginated hypofluorescent small dots. Cerebrospinal fluid pleocytosis was not detected. Blood tests revealed leukocytosis together with elevation of lactate dehydrogenase and soluble interleukin-2 receptor levels. Corticosteroid pulse therapy did not improve any ocular findings. Bone marrow biopsy was then performed, leading to a definite diagnosis of diffuse large B-cell lymphoma. After starting systemic chemotherapy, both SRD and choroidal thickening resolved rapidly with visual recovery. However, choroidal hypoperfusion persisted, which contrasted distinctly with the inflammatory pattern of VKH disease, i.e., the restoration of choroidal blood flow in parallel with normalization of choroidal thickness. Conclusions Our detailed multimodal observations highlighted the differential imaging features of choroidal lymphoma despite close resemblance to VKH disease especially at the initial stage. Impaired circulation in the thickened choroid marked the pseudo-inflammatory pathogenesis of SRD due to choroidal involvement with neoplastic, but not inflammatory cells.
資源タイプ	学術雑誌論文
出版タイプ	Version of Record
権利情報	Creative Commons Attribution 4.0 International
関連情報 (isIdenticalTo)	出版社版DOI https://doi.org/10.1186/s12886-020-01353-9