Gamma-delta T-cell lymphoma of skin, eye and brain presenting with visual loss.
Jones, N Gibb, Adam Irion, L Coupland, S
Jones, N
Gibb, Adam
Irion, L
Coupland, S
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Abstract
A young man presented with rapid, predominantly right-sided visual loss with a background of multifocal skin lesions. Visual acuity was right hand movements, left 6/5 Snellen, deteriorating to 6/38. He showed panuveitis with bilateral multifocal retinal infiltrates and retinal vasculitis. Multifocal brain lesions were identified. Biopsy of both skin and vitreous showed atypical lymphocytes, and immunohistochemistry confirmed T-cell lymphoma of gamma-delta subtype. Management with the CODOX-M/IVAC polychemotherapy regimen achieved rapid response including resolution of intraocular changes and substantial improvement of visual acuity to right 6/7.5, left 6/6. However, he relapsed before planned stem cell transplantation. Salvage with the gemcitabine/dexamethasone/cisplatin regimen, although temporarily effective, was followed by further relapse including widespread brain involvement, and he succumbed 10 months after presentation.
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2017-06-15
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Gamma-delta T-cell lymphoma of skin, eye and brain presenting with visual loss. 2017, 2017 BMJ Case Rep