Title: A Choroidal Lesion with Extrascleral Extension: A Case Report
Authors: Christopher D. Conrady, MD, PhD1, Kirk Winward, MD,2 and Roger Harrie, MD1*
1Department of Ophthalmology, John A. Moran Eye Center, University of Utah, Salt Lake City, UT 84112. 2Retina Associates of Utah, Murray, UT 84107
Keywords/Main Subjects: extrascleral, lymphoma, choroid, tumor
Diagnosis/Differential Diagnosis: choroidal lymphoma with extrascleral extension
Brief Description of Case: We present the case of a 64-year-old male with a choroidal lesion noted to have extrascleral extension subsequently identified as an isolated low-grade B-cell lymphoma by fine needle aspiration.
Figure 1 64-year-old man with extrascleral extension of ocular lymphoma.
(a) Fundus examination of the right eye identified an ill-defined, amelanotic, choroidal lesion temporal to the macula. Dotted green line indicates approximate borders of lesion. (b) Fluorescein angiogram identified a hyperflourescent mass with late leakage consistent with fundus examination. Dotted green line indicates approximate tumor borders. (c-d) A- and B-scan ultrasound identified a 3mm x 10mm x 10mm choroidal lesion with extrascleral extension [indicated by green arrow in (c) and blue arrow in (d)]. Lesion thickness further characterized by A-scan with yellow and green lines in (d). (e) Fine needle aspiration of the lesion identified a low grade B-cell lymphoma. Inset shows magnified cells of central box consistent with B lymphocytes.
Summary of Cases:
In conclusion, identifying extrascleral extension on A- and B-scan ultrasonography of a lesion helps narrow the differential diagnosis to choroidal lymphomas or melanomas and posterior scleritis.
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