Document Detail


Multifocal nodular episcleritis and scleritis with undiagnosed Hodgkin's lymphoma.
MedLine Citation:
PMID:  12750114     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To report the case of a patient with undiagnosed Hodgkin's lymphoma who presented with coexistent unilateral nodular episcleritis and scleritis. DESIGN: Interventional case report and literature review METHODS: Review of clinical history, laboratory findings, histology of episcleral and cervical lymph node biopsies, and follow-up. RESULTS: A 20-year-old female presented with a 5-month history of redness and pain in her left eye, with associated symptoms of dyspnea, malaise, and fever. The patient was found to have multifocal nodular episcleritis and scleritis that was not responsive to topical steroids or systemic nonsteroidal anti-inflammatory treatment. Laboratory tests subsequently revealed evidence of systemic inflammation, and radiologic studies showed extensive mediastinal and cervical adenopathy. A cervical lymph node biopsy showed Reed-Sternberg cells and a chronic lymphocytic infiltrate consistent with nodular sclerosing Hodgkin's lymphoma. Histopathologic analysis of an episcleral nodule revealed a necrotizing granuloma with vasculitis. Systemic chemotherapy was instituted for the Hodgkin's disease; this therapy abolished the nodular scleritis. CONCLUSIONS: This case raises the possibility of concurrent undiagnosed systemic vasculitis with only an ocular manifestation with Hodgkin's lymphoma, either as a coincidence or as a paraneoplastic syndrome. Moreover, it emphasizes the important role of tissue biopsy in establishing diagnosis and directing treatment.
Authors:
Manoj M Thakker; Victor L Perez; Alexandre Moulin; Sandra L Cremers; C Stephen Foster
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Ophthalmology     Volume:  110     ISSN:  0161-6420     ISO Abbreviation:  Ophthalmology     Publication Date:  2003 May 
Date Detail:
Created Date:  2003-05-16     Completed Date:  2003-05-30     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7802443     Medline TA:  Ophthalmology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1057-60     Citation Subset:  IM    
Copyright Information:
Copyright 2003 by the American Academy of Ophthalmology.
Affiliation:
Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Antineoplastic Agents / therapeutic use
Eye Neoplasms / diagnosis*,  drug therapy
Female
Hodgkin Disease / diagnosis*,  drug therapy
Humans
Lymph Nodes / pathology
Lymphatic Metastasis
Scleritis / drug therapy,  pathology*
Chemical
Reg. No./Substance:
0/Antineoplastic Agents

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