Figure 20-10 Large cell lymphoma, cytology. Note the unusual nuclei and prominent nucleoli (arrows) of these neoplastic lymphoid cells obtained by fine-needle aspiration biopsy.

Prognosis

The prognosis for patients with large cell lymphoma is poor, although advances in early diagnosis have produced a cohort of long-term survivors. Serial follow-up with consultative management by an experienced medical oncologist is critical in the management of this disease. Patients with PCNSL should be observed carefully by an ophthalmologist for possible ocular involvement, even after remission of the CNS disease.

Chan CC, Wallace DJ. Intraocular lymphoma: update on diagnosis and management. Cancer Control. 2004;11(5):285–295. Coupland SE, Damato B. Understanding intraocular lymphomas. Clin Exp Ophthalmol. 2008; 36(6):564–578.

Frenkel S, Hendler K, Siegal T, Shalom E, Pe’er J. Intravitreal methotrexate for treating vitreoretinal lymphoma. Ten years of experience. Br J Ophthalmol. 2008;92(3):383–388.

Uveal Lymphoid Infiltration

Uveal lymphoid infiltration, formerly known as reactive lymphoid hyperplasia, typically presents in patients in the sixth decade of life; it can occur at any uveal site. Similar lymphoid proliferation can occur in the conjunctiva and orbit (see also Chapter 5 for conjunctival involvement, Chapter 12 for uveal involvement, and Chapter 14 for orbital involvement).

Clinical evaluation