ABSTRACT

Herein, we describe two cases of intraocular lymphoma (IOL) masquerading as multifocal choroiditis with panuveitis (MCP). Each case presented with visual impairment. The first case (60 y old female) was diagnosed as having bilateral MCP, because of pre-existing immunological co-morbidities and good initial response to steroid treatment. However, her eyes got worse during the follow-up period, MRI of the brain was performed, showing central nervous system (CNS) lymphoma. The second case (58 y old male) presenting with unilateral MFC was suspected of having PIOL at the first visit and brain MRI showed some nonspecific findings, which could not be confirmed pathologically with vitreous biopsy. The lesion detected by MRI enlarged during the follow-up period and brain biopsy by neurosurgeons confirmed the diagnosis of diffuse large B-cell lymphoma. IOL should be kept in mind in elderly patients with atypical MCP showing a good initial response to steroid treatment, but recurring subsequently. Brain MRI should be ordered in such cases and cytologic examination of the vitreous specimen should be repeated, even after negative initial vitreous biopsy.