Primary Choroidal Malignant Lymphoma: Report of A Case and Review of Literature

Non-hodgkin lymphoma (nhl) is one of the masquerade syndromes of malignantmelanoma that can occur with two main patterns of presentations in the eye: metastatic involvement ofuveal tract, and primary involvement of retina. we report ophthalmic, imaging and histopathologicalfindings in the first case diagnosed as primary choroidal nhl without central nervous system orsystemic involvement. a 37-year-old woman presented with the complaint of severe visual loss in herright eye. significant ocular finding included light perception of vision (lp), 2+ apd, 2+ cells invitreous and intraocular pressure of 46 mmhg. fundoscopic examination revealed exudative retinaldetachment. ocular echography showed choroidal thickening in addition to retinal detachment. mrishowed semilunar shape lesion in the posterior right globe suggesting choroidal melanoma. systemicwork-up could not reveal any underlying cause. the patient underwent enucleation with clinicalsuggestion of choroidal melanoma. result of histological examination showed nhl (diffuse large bcelltype) of choroid. immunohistochemical staining showed negative staining for hmb-45 and cd3,positive staining for lca, and cd20. multiple periodic lumbar puncture, bone marrow biopsies andmri were unremarkable. no recurrence of tumor in systemic work-up was noted during the 36-monthsfollow-up. primary choroidal nhl is one of the causes of generalized thickening of choroid and shouldbe considered in differential diagnosis of malignant melanoma. it is recommended to perform fineneedle biopsy before performing surgery in any patient who has had an atypical malignant melanoma.this is, so far as we know, the first case diagnosed as primary choroidal nhl.