CONCLUSIONS: Thirty patients were identified with ophthalmic manifestation of HL. Thirteen (43%) were male, and 14 (46%) were female (in 3 cases, sex was not specified). The median age at ophthalmic presentation was 27 years. Diagnosis of HL was made after ophthalmic manifestation in 10 (33%) cases, whereas 11 (36%) cases had a prior diagnosis of HL. Ophthalmic manifestations can be classified into 3 main groups; direct infiltration, inflammatory reaction, and paraneoplastic process. Seven cases had infiltration of the optic nerve. Uveal inflammatory reaction was reported in 21 cases. The presence of intraocular Reed-Sternberg cells had been confirmed in 1 case with granulomatous uveitis. Conjunctival and corneal reaction was seen in 3 cases. HL was in stage 2 or higher, with only 1 case with stage 1A (12 cases HL stage not specified). Seven cases (22%) died of HD, all were diagnosed with advanced lymphoma, and none was treated with chemotherapy.
CONCLUSIONS: Ocular involvement in HL is extremely rare. A few cases of histopathologically confirmed optic nerve/tract infiltration are within the spectrum of CNS involvement by HL. Inflammatory uveitis is the most common ophthalmic association of HL. In the presence of prior known diagnosis of HL, restaging should be considered to exclude recurrence. Toxicity or adverse reaction to drugs used to treat HL may also contribute to ophthalmic involvement.
结论:30例患者被确定为HL的眼科表现。13人(43%)是男性,14例(46%)为女性(3例,未指定性别)。眼科就诊时的中位年龄为27岁。10例(33%)患者在眼科表现后诊断为HL,而11例(36%)病例先前诊断为HL。眼科表现可分为3组;直接浸润,炎症反应,和副肿瘤过程。7例视神经浸润。报告葡萄膜炎性反应21例。在1例肉芽肿性葡萄膜炎中已证实存在眼内Reed-Sternberg细胞。结膜和角膜反应3例。HL处于阶段2或更高,只有1例1A阶段(12例HL阶段未指定)。7例(22%)死于HD,都被诊断为晚期淋巴瘤,没有人接受化疗。
结论:HL的眼部受累极为罕见。少数经组织病理学证实的视神经/束浸润在HL累及CNS的范围内。炎性葡萄膜炎是HL最常见的眼科关联。在先前已知的HL诊断存在的情况下,应考虑重新分类以排除复发。用于治疗HL的药物的毒性或不良反应也可能导致眼科受累。