A case of primary peripheral T-cell type non-Hodgkin lymphoma originating in the iris: Clinico-pathological findings

Background. The ocular adnexal region is the primary localization of extranodal lymphoma in 5% to 15% of all Non-Hodgkin lymphoma. Intraocular lymphoma of T-cell origin is extremely rare and such sites of infiltration have been rarely observed in clinical examination. Case report. We presented a 56-year-old man with iris infiltration by primary intraocular peripheral T-cell lymphoma. The patient was in clinical stage I BE and the treatment was initiated according to cyclophosphamide, hydroxydaunorubicin, oncovin, prednisone (CHOP) regimen. When the second course of the therapy was scheduled, the patient developed central nervous system lymphoma infiltration. Although De Angelis regimen was used, 3 months after the diagnosis was established, lethal outcome ensued due to disease progression. Conclusion. According to our experience we can conclude that further therapeutical approach to patients with primary intraocular Tcell lymphoma requires modification of conventional treatment regimens. The lower median survival in these patients suggests that the disease may be of more aggressive course. Uvod. Okularni adneksi su primarna lokalizacija ekstranodalnih limfoma kod 5-15% svih non-Hodgkin limfoma. Intraokularni limfom T-celijskog porekla je redak i u dosadasnjoj klinickoj praksi nije zabelezeno mnogo ovakvih slucajeva. Prikaz bolesnika. Prikazali smo bolesnika, starog 56 godina, sa infiltracijom duzice primarnim perifernim T-celijskim limfomom. Bolesnik je inicijalno bio u I BE klinickom stadijumu i zapoceto je lecenje prema ciklofosfamid, hidroksidaunorubicin, onkovin, prednizon (CHOP) terapijskom protokolu. U terminu kada je zakazan drugi terapijski ciklus potvrdjena je infiltracija centralnog nervnog sistema. Iako je lecenje nastavljeno prema De Angelis protokolu, doslo je do progresije bolesti i smrtnog ishoda tri meseca nakon postavljanja dijagnoze. Zakljucak. Na osnovu naseg iskustva mozemo da zakljucimo da konvencionalni terapijski pristup u lecenju bolesnika sa primarnim intraokularnim T-celijskim limfomom zahteva modifikaciju. Niza stopa prezivljavanja ovih bolesnika ukazuje na to da bolest moze imati agresivniji tok.