CD5-Positive Primary Intraocular B-Cell Lymphoma Arising during Methotrexate and Tumor Necrosis Factor Inhibitor Treatment
Purpose: To report a case of CD5+ primary intraocular B-cell lymphoma arising during methotrexate (MTX) and tumor necrosis factor (TNF) inhibitor treatment in a young patient with rheumatoid arthritis and uveitis. Case Presentation: A 39-year-old woman treated with MTX and a TNF inhibitor for rheuma...
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| Format: | Article |
| Language: | English |
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Karger Publishers
2015-09-01
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| Series: | Case Reports in Ophthalmology |
| Subjects: | |
| Online Access: | http://www.karger.com/Article/FullText/440646 |
| _version_ | 1818127307008638976 |
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| author | Kenji Nagata Tohru Inaba Shigeru Kinoshita |
| author_facet | Kenji Nagata Tohru Inaba Shigeru Kinoshita |
| author_sort | Kenji Nagata |
| collection | DOAJ |
| description | Purpose: To report a case of CD5+ primary intraocular B-cell lymphoma arising during methotrexate (MTX) and tumor necrosis factor (TNF) inhibitor treatment in a young patient with rheumatoid arthritis and uveitis. Case Presentation: A 39-year-old woman treated with MTX and a TNF inhibitor for rheumatoid arthritis and uveitis had steroid-resistant vitreous opacity. A vitreous sample was obtained by using diagnostic vitrectomy and was categorized as class V based on cytologic examination. Flow cytometric analysis of the vitreous sample revealed that abnormal cells were CD5+, CD10-, CD19+, CD20+ and immunoglobulin light-chain kappa+, suggesting the diagnosis of CD5+ primary intraocular B-cell lymphoma. Polymerase chain reaction (PCR) detected immunoglobulin heavy-chain gene rearrangement. Epstein-Barr virus (EBV) DNA was detected in the vitreous sample by using PCR, and immunohistochemistry revealed EBV latent membrane protein-1 expression in the abnormal cells infiltrating the vitreous. Optic nerve invasion was observed on magnetic resonance imaging. Conclusion: Primary intraocular lymphoma (PIOL) may develop in patients receiving MTX and TNF inhibitor treatment. EBV infection may play an important role in the pathogenesis of PIOL arising during immunosuppressive therapy. |
| first_indexed | 2024-12-11T07:15:16Z |
| format | Article |
| id | doaj.art-cac070c0780b4a099033a9bbce93f739 |
| institution | Directory Open Access Journal |
| issn | 1663-2699 |
| language | English |
| last_indexed | 2024-12-11T07:15:16Z |
| publishDate | 2015-09-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Case Reports in Ophthalmology |
| spelling | doaj.art-cac070c0780b4a099033a9bbce93f7392022-12-22T01:16:15ZengKarger PublishersCase Reports in Ophthalmology1663-26992015-09-016330130610.1159/000440646440646CD5-Positive Primary Intraocular B-Cell Lymphoma Arising during Methotrexate and Tumor Necrosis Factor Inhibitor TreatmentKenji NagataTohru InabaShigeru KinoshitaPurpose: To report a case of CD5+ primary intraocular B-cell lymphoma arising during methotrexate (MTX) and tumor necrosis factor (TNF) inhibitor treatment in a young patient with rheumatoid arthritis and uveitis. Case Presentation: A 39-year-old woman treated with MTX and a TNF inhibitor for rheumatoid arthritis and uveitis had steroid-resistant vitreous opacity. A vitreous sample was obtained by using diagnostic vitrectomy and was categorized as class V based on cytologic examination. Flow cytometric analysis of the vitreous sample revealed that abnormal cells were CD5+, CD10-, CD19+, CD20+ and immunoglobulin light-chain kappa+, suggesting the diagnosis of CD5+ primary intraocular B-cell lymphoma. Polymerase chain reaction (PCR) detected immunoglobulin heavy-chain gene rearrangement. Epstein-Barr virus (EBV) DNA was detected in the vitreous sample by using PCR, and immunohistochemistry revealed EBV latent membrane protein-1 expression in the abnormal cells infiltrating the vitreous. Optic nerve invasion was observed on magnetic resonance imaging. Conclusion: Primary intraocular lymphoma (PIOL) may develop in patients receiving MTX and TNF inhibitor treatment. EBV infection may play an important role in the pathogenesis of PIOL arising during immunosuppressive therapy.http://www.karger.com/Article/FullText/440646Primary intraocular lymphomaCD5+ B-cell lymphomaMethotrexateTumor necrosis factor inhibitorEpstein-Barr virus |
| spellingShingle | Kenji Nagata Tohru Inaba Shigeru Kinoshita CD5-Positive Primary Intraocular B-Cell Lymphoma Arising during Methotrexate and Tumor Necrosis Factor Inhibitor Treatment Case Reports in Ophthalmology Primary intraocular lymphoma CD5+ B-cell lymphoma Methotrexate Tumor necrosis factor inhibitor Epstein-Barr virus |
| title | CD5-Positive Primary Intraocular B-Cell Lymphoma Arising during Methotrexate and Tumor Necrosis Factor Inhibitor Treatment |
| title_full | CD5-Positive Primary Intraocular B-Cell Lymphoma Arising during Methotrexate and Tumor Necrosis Factor Inhibitor Treatment |
| title_fullStr | CD5-Positive Primary Intraocular B-Cell Lymphoma Arising during Methotrexate and Tumor Necrosis Factor Inhibitor Treatment |
| title_full_unstemmed | CD5-Positive Primary Intraocular B-Cell Lymphoma Arising during Methotrexate and Tumor Necrosis Factor Inhibitor Treatment |
| title_short | CD5-Positive Primary Intraocular B-Cell Lymphoma Arising during Methotrexate and Tumor Necrosis Factor Inhibitor Treatment |
| title_sort | cd5 positive primary intraocular b cell lymphoma arising during methotrexate and tumor necrosis factor inhibitor treatment |
| topic | Primary intraocular lymphoma CD5+ B-cell lymphoma Methotrexate Tumor necrosis factor inhibitor Epstein-Barr virus |
| url | http://www.karger.com/Article/FullText/440646 |
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