This article is more than 5 years old. Information may no longer be current.

Experienced pathologists needed to diagnose intraocular lymphoma

Add topic to email alerts

Receive an email when new articles are posted on

Please provide your email address to receive an email when new articles are posted on .

Subscribe

Added to email alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

Back to Healio

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Back to Healio

KAANAPALI, Hawaii — A successful diagnosis of intraocular lymphoma depends on the knowledge of the pathologist, a presenter said.

The primary reasons why an intraocular lymphoma diagnosis is missed are due to poor handling of the specimen and lack of an experienced pathologist, Daniel F. Martin, MD, told colleagues at Retina 2011, adding that it is essential for physicians to be comfortable dealing with such small specimens and to have experience making the diagnosis.

Intraocular lymphoma has a range of appearances, but several recognizable patterns are commonly seen. Typically a large B cell lymphoma involves subretinal pigment epithelium space with some spillover into vitreous, Dr. Martin explained. It manifests in the central nervous system-ocular axis and rarely extends elsewhere. Typical age of presentation is in the 50s and 60s, not in the 70s as would be expected, he said.

"The majority of patients I've seen actually had unilateral disease when they first presented. They usually become bilateral, but do not be surprised if it's unilateral when you first see it," Dr. Martin said.

The first-line treatment at many centers is methotrexate-based systemic chemotherapy. Radiation, formerly a popular treatment choice, is now mostly reserved for relapses.

Dr. Martin's said his usual treatment regimen comprises weekly intravitreal methotrexate injections for 4 weeks, followed by monthly injections. If the patient relapses, the cycle injections would start again.

"I still usually recommend systemic therapy because almost all of these patients have occult [central nervous system] disease; it just hasn't manifested yet," Dr. Martin said, noting he would move to radiation therapy fairly quickly.

• Disclosure: Daniel F. Martin, MD, has no financial relationships to disclose.

Hawaiian Eye and Retina 2012 will be held January 15-20 at the Grand Wailea Resort & Spa in Maui. Learn more at OSNHawaiianEye.com or RetinaMeeting.com.