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Metastatic B-cell lymphoma masquerading as infectious retinitis and vasculitis.

Oncol Lett

June 2012

Kittner Eye Center, University of North Carolina Hospitals (EATS, KRG, SHC), Ambulatory Care Center, Chapel Hill, NC 27599-7040; Leo W. Jenkins Cancer Center, Eastern Carolina University (CLK), Greenville, NC 27834, USA.

Intraocular lymphoma is a rare ocular malignancy that may occur in the retina or the uvea. Retina or vitreoretinal lymphoma accounts for the majority of cases and is often secondary to diffuse large B-cell lymphoma. In the present study, a 66-year-old Caucasian male with a history of Waldenstrom's macroglobulinemia with diffuse large B-cell lymphoma, presented with blurred vision in the left eye one month following cycle 4 of an R-CHOP regimen.

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A 57-year-old woman with a history of transient ischaemic attacks and six recurrent foetal losses accompanied by elevations of antiphospholipid antibodies was diagnosed as having a "primary" antiphospholipid syndrome. She was followed up for 5 years, and she developed anaemia, leucopenia and splenomegaly. A bone marrow trephine was diagnostic of Waldenstrom's macroglobulinaemia.

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In a series of 42 positive sera, anti-mitochondrial type M5 antibodies (AMA-M5) were found most frequently in patients with SLE (24) and SLE-like syndromes. Patients with AMA-M5 displayed a higher prevalence of thrombocytopenia, thrombosis, biological false positive seroreactions for syphilis, lupus-like anticoagulant activity and anti-cardiolipin antibodies in comparison with a group of 43 SLE AMA-M5 negative patients. The strong association between anti-phospholipid and AMA-M5 antibodies cannot be explained entirely by cross-reactivity between these two groups of antibodies, as indicated by absorption experiments and studies using affinity purified antibody preparations.

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We report here the characterization and fine specificity of a human monoclonal IgM lambda reacting with double stranded DNA. The purified IgM and its Fab fragment bind to DNA in the Farr or Crithidia lucilae assays as well as in an immunoenzymatic test. In the latter case, binding was inhibited by native DNA, by DNA alternative co-polymers and by some homopolymers only, but not by monodeoxyribonucleotides and ribonucleotides.

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