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Sight-threatening optic neuropathy is associated with paranasal lymphoma

Authors Hayashi T, Watanabe K, Tsuura Y, Tsuji G, Koyama S, Yoshigi J, Hirata N, Yamane S, Iizima Y, Toyota S, Takeuchi S

Published 9 March 2010 Volume 2010:4 Pages 143—146


Review by Single-blind

Peer reviewer comments 3

Takahiko Hayashi1, Ken Watanabe2, Yukio Tsuura3, Gengo Tsuji4, Shingo Koyama4, Jun Yoshigi4, Naoko Hirata1, Shin Yamane1, Yasuhito Iizima5, Shigeo Toyota6, Satoshi Takeuchi1

1Department of Ophthalmology, Yokosuka Kyosai Hospital, Japan; 2Department of Hematology, Graduate School of Medicine, Tokyo Medical and Dental University, Japan; 3Department of Pathology, Yokosuka Kyosai Hospital, Japan; 4Department of Radiology, Yokosuka Kyosai Hospital, Japan; 5Department of Ophthalmology, Yokohama City University, Japan; 6Department of Internal Medicine, Yokosuka Kyosai Hospital, Japan

Abstract: Malignant lymphoma around the orbit is very rare. We present a rare case of optic neuropathy caused by lymphoma. A 61-year-old Japanese woman was referred to our hospital for evaluation of idiopathic optic neuropathy affecting her right eye. The patient was treated with steroid pulse therapy (methyl-predonisolone 1 g daily for 3 days) with a presumed diagnosis of idiopathic optic neuritis. After she had been switched to oral steroid therapy, endoscopic sinus surgery had been performed, which revealed diffuse large B cell lymphoma of the ethmoidal sinus. Although R-CHOP therapy was immediately started, prolonged optic nerve compression resulted in irreversible blindness. Accordingly, patients with suspected idiopathic optic neuritis should be carefully assessed when they show a poor response, and imaging of the orbits and brain should always be done for initial diagnosis because they may have compression by a tumor.

Keywords: optic neuropathy, malignant lymphoma, paranasal lymphoma, rhinogenic optic neuropathy

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