case_images: PMC8495122_01
case_images: Findings from a 25-year-old man presenting with anterior chamber inflammation, vitreous opacity, and increased intraocular pressure in the left eye. (A) Slitlamp photograph showing anterior chamber reaction (keratic precipitates 1+, flare 1+, cell 1+). (B) B-Scan revealing vitreous opacity and a plurality of white lumps on the surface of inferior retina. (C) Ultrasonographic biomicroscopy showing local masses with acoustic solidity but low internal reflectivity. (D) Liquid-based cytology test (hematoxylin-erosin; original manification, x 40) showing large atypical lymphoid cells.
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case_images: PMC8495122_01_fonc-11-718759-g001.jpg
case_images: f1
case_images: Our ophthalmological examination revealed an elevated IOP (34.1 mmHg, 1 mmHg=0.133 kPa), anterior chamber reaction (keratic precipitates 1+, flare 1+, cell 1+) ( Figure 1A ), vitreous opacity and a plurality of white lumps on the surface of the inferior retina in the left eye. B-scan revealed vitreous opacity and epiretinal deposits, and ultrasound biomicroscopy (UBM) found a ciliary body mass with almost 360  involvement in the left eye ( Figures 1B, C ). Liquid-based cytology revealed large atypical lymphoid cells that were CD20+ on flow cytometry ( Figure 1D  and  Table 1 ).
case_images: PMC8495122_02
case_images: Findings from a 52-year-old woman presenting with visual deterioration in the right eye. (A) Slitlamp photograph showing conjunctival congestion and edema, anterior chamber reaction (keratic precipitates +, flare 2+, cell 1+), posterior synechia of the inferior part of the iris, and superior nasal part of the peripheral anterior chamber obliterated. (B) Ultrasonographic biomicroscopy revealing 360   infiltration of conjunctiva, iris, and ciliary body with low and medium internal reflectivity. (C) Photomicrograph of vitreous biopsy (hematoxylin-erosin; original manification, x 200) showing small malignant cells. (D) Photomicrograph of conjunctival biopsy (hematoxylin-erosin; original manification, x 200) showing small malignant cells. (E) Slitlamp photograph demonstrating conjunctival congestion and edema, anterior chamber reaction relieved significantly after treatment. (F) Ultrasonographic biomicroscopy showing lesions of ciliary body basically disappeared after treatment.
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case_images: Slit-lamp examination of the right eye revealed anterior chamber reaction (keratic precipitates+, flare 2+, cell 1+), posterior synechia of the inferior part of the iris, and obliteration of the superior nasal part of the peripheral anterior chamber ( Figure 2A ). UBM of the right eye revealed 360  infiltration of the conjunctiva, iris, and ciliary body with low and medium internal reflectivity, more prominent on the superior nasal side ( Figure 2B ). Pathology revealed small malignant cells in the vitreous humor and bulbar conjunctiva ( Figures 2C, D ), which were then confined to be NKTL in origin by immunohistochemistry [CD2(+), Ki-67(index 85%), CD3(+), CD4(+), CD56(+), granzymeB(+)], gene rearrangement studies [TCRG(+)], and in-situ hybridization [EBER(+)] ( Table 1 ). UBM reexamination showed complete regression of the ciliary body lesions ( Figures 2E, F ).
case_images: PMC8495122_03
case_images: Findings from a 54-year-old man presenting with redness, pain and blurred vision in both eyes. (A, E) Slitlamp photograph showing severe anterior chamber reaction (keratic precipitates 3+, flare 1+, cell 4+), and a pseudohypopyon in the right and left eye, respectively. (B, F) Dilation examination revealing an invisible fundus in the right and left eye. (C, G) Ultrasonographic biomicroscopy revealing revealed 360  thickening of the iris and ciliary body, plus peripheral angle closure in the right and left eye, respectively. (D) Liquid-based cytology test of aqueous and vitreous humor (hematoxylin-erosin; original manification, x 40) showing atypical lymphoid cells.
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case_images: BCVA was 20/100 in the right eye and 20/200 in the left eye, and his IOP was 42 mmHg and 45 mmHg in the right and left eyes, respectively. Biomicroscopic examination of both eyes showed severe anterior chamber reaction (keratic precipitates 3+, flare 1+, cell 4+) and a pseudohypopyon in the inferior angle ( Figures 3A, E ). B-scan demonstrated clear vitreous and an absence of fundus anomalies ( Figures 3B, F ). UBM revealed 360  thickening of the iris and ciliary body, plus peripheral angle closure ( Figures 3C, G ). Liquid-based cytology revealed atypical lymphoid cells ( Figure 3D ), which were IgK and IgH on gene rearrangement analysis ( Table 1 ).