Cytomegalovirus retinitis mimicking intraocular lymphoma

Patrick Gooi1, James Farmer2, Bernard Hurley3, Elliott Brodbaker41Department of Ophthalmology, University of Calgary, Calgary, Alberta, Canada; 2Department of Pathology and Lab Medicine University of Ottawa and The Ottawa Hospital, Ottawa, Ontario, Canada; 3Department of Ophthalmology, University of...

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Autores principales:	Patrick Gooi, James Farmer, Bernard Hurley, Elliott Brodbaker
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2008
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/63995366aa114783be0b6b4f70d66894
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spelling	oai:doaj.org-article:63995366aa114783be0b6b4f70d668942021-12-02T01:06:32ZCytomegalovirus retinitis mimicking intraocular lymphoma1177-54671177-5483https://doaj.org/article/63995366aa114783be0b6b4f70d668942008-12-01T00:00:00Zhttp://www.dovepress.com/cytomegalovirus-retinitis-mimicking-intraocular-lymphoma-a2755https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Patrick Gooi1, James Farmer2, Bernard Hurley3, Elliott Brodbaker41Department of Ophthalmology, University of Calgary, Calgary, Alberta, Canada; 2Department of Pathology and Lab Medicine University of Ottawa and The Ottawa Hospital, Ottawa, Ontario, Canada; 3Department of Ophthalmology, University of Ottawa Eye Institute and The Ottawa Hospital, Ottawa, Ontario, Canada; 4Faculty of Medicine, University of Ottawa, Ottawa, Ontario, CanadaAbstract: We present a case of an unusual retinal infiltrate requiring retinal biopsy for definitive diagnosis. A 62-year-old man with treated lymphoma presented with decreased vision in the right eye associated with a white retinal lesion, which extended inferonasally from an edematous disc. Intraocular lymphoma was considered as a diagnosis; thus, the patient was managed with vitrectomy and retinal biopsy. Cytological analysis of the vitreous aspirate could not rule out a lymphoproliferative disorder. The microbial analysis was negative. Histology of the lesion showed extensive necrosis and large cells with prominent nucleoli. To rule out lymphoma, a battery of immunostains was performed and all were negative. However the limited amount of tissue was exhausted in the process. Subsequently, a hematoxylin and eosin (H/E) slide was destained, on which a CMV immunostain was performed. This revealed positivity in the nuclei and intranuclear inclusions within the large atypical cells. A diagnosis of CMV retinitis was made. Retinal biopsy may provide a definitive diagnosis and direct patient care toward intravenous gancyclovir in the case of CMV or toward radiation and chemotherapy for intraocular lymphoma. When faced with a limited amount of tissue, destaining regular H/E slides is a possible avenue to performing additional immunohistochemical studies.Keywords: CMV retinitis, retinal biopsy, immunohistochemistry, destaining Patrick GooiJames FarmerBernard HurleyElliott BrodbakerDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2008, Iss Issue 4, Pp 969-971 (2008)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Patrick Gooi James Farmer Bernard Hurley Elliott Brodbaker Cytomegalovirus retinitis mimicking intraocular lymphoma
description	Patrick Gooi1, James Farmer2, Bernard Hurley3, Elliott Brodbaker41Department of Ophthalmology, University of Calgary, Calgary, Alberta, Canada; 2Department of Pathology and Lab Medicine University of Ottawa and The Ottawa Hospital, Ottawa, Ontario, Canada; 3Department of Ophthalmology, University of Ottawa Eye Institute and The Ottawa Hospital, Ottawa, Ontario, Canada; 4Faculty of Medicine, University of Ottawa, Ottawa, Ontario, CanadaAbstract: We present a case of an unusual retinal infiltrate requiring retinal biopsy for definitive diagnosis. A 62-year-old man with treated lymphoma presented with decreased vision in the right eye associated with a white retinal lesion, which extended inferonasally from an edematous disc. Intraocular lymphoma was considered as a diagnosis; thus, the patient was managed with vitrectomy and retinal biopsy. Cytological analysis of the vitreous aspirate could not rule out a lymphoproliferative disorder. The microbial analysis was negative. Histology of the lesion showed extensive necrosis and large cells with prominent nucleoli. To rule out lymphoma, a battery of immunostains was performed and all were negative. However the limited amount of tissue was exhausted in the process. Subsequently, a hematoxylin and eosin (H/E) slide was destained, on which a CMV immunostain was performed. This revealed positivity in the nuclei and intranuclear inclusions within the large atypical cells. A diagnosis of CMV retinitis was made. Retinal biopsy may provide a definitive diagnosis and direct patient care toward intravenous gancyclovir in the case of CMV or toward radiation and chemotherapy for intraocular lymphoma. When faced with a limited amount of tissue, destaining regular H/E slides is a possible avenue to performing additional immunohistochemical studies.Keywords: CMV retinitis, retinal biopsy, immunohistochemistry, destaining
format	article
author	Patrick Gooi James Farmer Bernard Hurley Elliott Brodbaker
author_facet	Patrick Gooi James Farmer Bernard Hurley Elliott Brodbaker
author_sort	Patrick Gooi
title	Cytomegalovirus retinitis mimicking intraocular lymphoma
title_short	Cytomegalovirus retinitis mimicking intraocular lymphoma
title_full	Cytomegalovirus retinitis mimicking intraocular lymphoma
title_fullStr	Cytomegalovirus retinitis mimicking intraocular lymphoma
title_full_unstemmed	Cytomegalovirus retinitis mimicking intraocular lymphoma
title_sort	cytomegalovirus retinitis mimicking intraocular lymphoma
publisher	Dove Medical Press
publishDate	2008
url	https://doaj.org/article/63995366aa114783be0b6b4f70d66894
work_keys_str_mv	AT patrickgooi cytomegalovirusretinitismimickingintraocularlymphoma AT jamesfarmer cytomegalovirusretinitismimickingintraocularlymphoma AT bernardhurley cytomegalovirusretinitismimickingintraocularlymphoma AT elliottbrodbaker cytomegalovirusretinitismimickingintraocularlymphoma
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Cytomegalovirus retinitis mimicking intraocular lymphoma

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