| 발표일자: |
2019년 4월 5일(금)~7(일) |
| 발표번호: |
P(e-poster)-274 |
| 발표장소: |
벡스코 전시장 1홀 내 |
|
|
| Central Nervous System Relapse in Lymphoreticular Malignancies: A case series and literature review |
| Universiti Sains Malaysia (1) |
| Mas edi putriku intan bt Ab kahar (1), Awis-Qarni Fadil (1), Mohammad Hudzaifah N(1), Evelyn Tai(1), Wan Hazabbah Wan Hitam (1) |
|
Purpose : To report four different clinical profile of lymphoreticular malignancy with central nervous system(CNS) relapse presented with subtle visual disturbance and disc edema in Hospital University Sains Malaysia.We provide literature review regarding outcome of CNS relapse in bilateral optic disc infiltration.
Methods : A retrospective review of patient’s medical records was done. Patients charts were analyzed for data including; age at presentation, initial eye symptoms, diagnostic investigations including imaging, primary treatment given and patient morbidity were evaluated.
Results : In our series, there were 4 cases with infiltrative optic neuropathy secondary to lymphoproliferative disorders occur in age between 17-49 years old. Males and females are equally distributed. Out of 4 patients, two were diagnosed to have Non-Hodgkin lymphoma, one case with Hodgkin lymphoma and one with B-cell acute lymphoblastic leukemia. All of patients presented with an acute reduced vision. Three cases had increased intracranial pressure symptoms and diplopia. Visual acuity upon presentation range from 6/6 to counting finger. Three cases had bilateral optic nerve swelling. Computer tomography scan in all patients showed involvement of optic nerve. Two patients had obvious lesion in the brain with hydrocephalus. One patient had lesion at the temporal bone that extended to the parapharyngeal area. One patient had no involvement of the brain. All patients received specific regime of chemotherapy. Three patients with central nervous system lymphoma had poor outcome. One patient with sole optic nerve involvement, survived.
Conclusion : Sudden vision disturbance in a patient with underlying lymphoreticular malignancy should be followed by prompt and through ophthalmology assessment even though patient has reached remission. Subtle eye symptoms can only be the only presenting symptoms indicating CNS relapse. Thus, early initiation of more aggressive chemo-radiotherapy should be considered in CNS relapse as delayed treatment leads to grave prognosis.
|
| |