Intraocular Metastatic Lung Adenocarcinoma Masquerading as an Intermediate Uveitis.

IF 2.6 4区 医学 Q2 OPHTHALMOLOGY
Robert D Nguyen, Itamar Livnat, Vimal Krishnan, Jay M Stewart, John A Gonzales
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引用次数: 0

Abstract

Purpose: To report on the clinical and cytopathological features of metastatic lung adenocarcinoma to the eye masquerading as an intermediate uveitis.

Methods: Retrospective chart review.

Results: A 63-year-old woman with a history of lung adenocarcinoma in remission presented with progressive vision loss and floaters in the right eye. Clinically, her uveitis was classified as a non-granulomatous anterior/intermediate uveitis. Pars plana vitrectomy was performed and cytopathology of the vitreous was unremarkable but directed polymerase chain reaction (PCR) was positive for HSV-1. Despite dual antiviral and antibiotic therapy, her visual acuity and intraocular inflammation progressively worsened prompting repeat vitrectomy with cytopathology revealing metastatic adenocarcinoma.

Conclusion: Intraocular metastatic lung adenocarcinoma can masquerade as an intermediate uveitis, presenting significant diagnostic challenges. Early and repeated cytopathological analysis of vitreous samples is crucial when the diagnosis remains uncertain, as it can lead to timely and accurate identification of metastatic carcinoma, thereby improving patient management and outcomes. This case underscores the diagnostic challenges and clinical complexity of distinguishing intraocular metastatic lung adenocarcinoma from intermediate uveitis.

伪装成中度葡萄膜炎的眼内转移性肺腺癌。
目的:报道伪装成中度葡萄膜炎的转移性肺腺癌的临床和细胞病理学特征。方法:回顾性图表复习。结果:一名63岁女性,有肺腺癌病史,缓解期,表现为进行性视力丧失和右眼飞蚊症。临床上,她的葡萄膜炎被归类为非肉芽肿性前/中间葡萄膜炎。行玻璃体切除,玻璃体细胞病理无明显变化,但定向聚合酶链反应(PCR) HSV-1阳性。尽管双重抗病毒和抗生素治疗,她的视力和眼内炎症逐渐恶化,促使再次玻璃体切除术,细胞病理学显示转移腺癌。结论:眼内转移性肺腺癌可以伪装成中度葡萄膜炎,提出了重大的诊断挑战。当诊断不确定时,对玻璃体样本进行早期和重复的细胞病理学分析至关重要,因为它可以及时准确地识别转移性癌,从而改善患者的管理和预后。本病例强调了鉴别眼内转移性肺腺癌与中度葡萄膜炎的诊断挑战和临床复杂性。
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来源期刊
CiteScore
6.20
自引率
15.20%
发文量
285
审稿时长
6-12 weeks
期刊介绍: Ocular Immunology & Inflammation ranks 18 out of 59 in the Ophthalmology Category.Ocular Immunology and Inflammation is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and vision scientists. Published bimonthly, the journal provides an international medium for basic and clinical research reports on the ocular inflammatory response and its control by the immune system. The journal publishes original research papers, case reports, reviews, letters to the editor, meeting abstracts, and invited editorials.
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