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Demonstration of identical clonal derivation in a case of “oculocerebral” lymphoma

Primary intraocular lymphoma (PIOL) is a high grade malignant non-Hodgkin’s lymphoma (NHL) usually of B cell type, involving the retina and vitreous. PIOL can occur independently or together with primary central nervous system lymphoma (PCNSL; the combination termed “oculocerebral lymphoma”). Because of its slow onset and ability to simulate other conditions, the diagnosis of PIOL remains challenging. A number of techniques, including conventional cytology, immunocytology, flow cytometry, polymerase chain reaction (PCR), and biochemical analysis of vitreous samples, are recommended to aid the diagnostic procedure.1–8 We report a case of oculocerebral lymphoma, whereby IgH-PCR and GeneScan analysis confirmed the histological diagnosis by demonstration of the identical clonal B cell populations in both the vitreous and stereotactic biopsy.

A 51 year old systemically healthy man presented in March 2002 with an epileptic fit. Cranial magnetic resonance imaging demonstrated a mass with intensive contrast enhancement in the left fronto-parietal area. A stereotactic biopsy was performed, establishing the diagnosis of a high grade malignant B …