Ocular Masquerade Syndrome Associated With Extranodal Nasal Natural Killer/t-cell Lymphoma: Case Report

A 33-year-old woman complained of unilateral eyelid edema and blurred vision. Initial ophthalmic examination disclosed anterior chamber reaction with keratic precipitates on the cornea, without posterior abnormalities. Anterior uveitis was treated. Despite that, patient showed rapidly progressive unilateral vision loss with optic nerve swelling. Systemic workup was inconclusive, as well as cranial magnetic resonance imaging and cerebrospinal fluid examination. Based on the hypothesis of optic neuritis, intravenous methylprednisolone pulse was performed with no success. During the following days, the patient presented pericardial effusion and cardiac tamponade, progressing to death. Necropsy was performed and diagnosis of extranodal natural killers/T-cell lymphoma, nasal type with ocular involvement was confirmed by immunohistochemistry.756430432Nussenblatt, R.B., Whitcup, S.M., Uveitis: fundamentals and clinical practice (2004), pp. 409-419. , 3rd ed. St. Louis, MO: CV MosbyTheodore, F.H., Conjunctival carcinoma masquerading as chronic conjunctivitis (1967) Eye Ear Nose Throat Mon, 46 (11), pp. 1419-1420Swerdlow, S.H., Campo, E., Harris, N.L., Jaffe, E.S., Pileri, S.A., Stein, H., Thiele, J., Vardiman, J.W., World classification of tumours of haematopoietic and lymphoid tissues (2008), 5th ed. Lyon: IARC PressCoupland, S.E., Damato, B., Lymphomas involving the eye and the ocular adnexa (2006) Curr Opin Ophthalmol, 17 (6), pp. 523-531Sjö, L.D., Ophthalmic lymphoma: epidemiology and pathogenesis (2009) Acta Ophthalmologica, 87 (1 THESIS), pp. 1-20Fredrick, D.R., Char, D.H., Ljung, B.M., Brinton, D.A., Solitary intraocular lymphoma as an initial presentation of widespread disease (1989) Arch Ophthalmol, 107 (3), pp. 395-397Chan, J.K.C., Jaffe, E.S., Ralfkiaer, E., Extranodal NK/Tcell lymphoma, nasal type. World classification of tumours of haematopoietic and lymphoid tissues (2008), pp. 204-207. , Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, Thiele J, Vardiman JW, editors. 5th ed. Lyon: IARC PressKwong, Y.L., Chan, A.C., Liang, R.H., Natural Killer cell lymphoma/leukaemia: pathology and treatment (1997) Hematol Oncol, 15 (2), pp. 71-79Jaffe, E.S., Chan, J.K., Su, I.J., Frizzera, G., Mori, S., Feller, A.C., Ho, F.C., Report of the Workshop on Nasal and Related Extranodal Angiocentric T/Natural Killer cell lymphomas: definitions, differential diagnosis and epidemiology (1996) Am J Surg Pathol, 20 (1), pp. 103-111Cimino, L., Chan, C.C., Shen, D., Masini, L., Ilariucci, F., Masetti, M., Asioli, S., Ocular involvement in nasal natural kille T-cell lymphoma (2009) Int Ophthalmol, 29 (4), pp. 275-279Lee, E.J., Kim, T.W., Heo, J.W., Yu, H.G., Chung, H., Natural killer/T-cell lymphoma of nasal type with intraocular involvement: case report. (2010) Eur J Ophthalmol, 20 (1), pp. 215-217Yoo, J.H., Kim, S.Y., Jung, K.B., Lee, J.J., Lee, S.J., Intraocular involvement of a nasal natural killer T-cell lymphoma: a case report (2012) Korean J Ophthalmol, 26 (1), pp. 54-57Hon, C., Kwok, A.K., Shek, T.W., Chim, J.C., Au, W.Y., Vision-threatening complications of nasal T/NK lymphoma (2002) Am J Ophthalmol, 134 (3), pp. 406-41