RESUMO
The clinical efficacy of rituximab therapy in systemic mucosa-associated lymphoid tissue (MALT) lymphoma with both periocular and intraocular involvement is described. Ophthalmic examination and radiologic imaging demonstrated tumor with bilateral periorbital, lacrimal, and subconjunctival infiltration, a pseudohypopyon in one eye, and extensive systemic lymph node involvement. Lymph node biopsy confirmed the pathologic findings of a low-grade MALT lymphoma. The patient had a complete remission within 3 months of starting rituximab therapy. A recurrence 6 months later remitted with a second round of rituximab therapy and the patient remained tumor-free at 1 year.
Assuntos
Anticorpos Monoclonais/uso terapêutico , Antineoplásicos/uso terapêutico , Neoplasias Oculares/terapia , Linfoma de Zona Marginal Tipo Células B/terapia , Androstadienos/uso terapêutico , Anticorpos Monoclonais Murinos , Tartarato de Brimonidina , Quimioterapia Combinada , Neoplasias Oculares/patologia , Feminino , Glaucoma/tratamento farmacológico , Humanos , Latanoprosta , Etabonato de Loteprednol , Linfoma de Zona Marginal Tipo Células B/patologia , Pessoa de Meia-Idade , Neoplasias Parotídeas/secundário , Prostaglandinas F Sintéticas/uso terapêutico , Quinoxalinas/uso terapêutico , Rituximab , Sulfonamidas/uso terapêutico , Tiofenos/uso terapêutico , Timolol/uso terapêuticoRESUMO
We describe a patient with Whipple's disease who had an unusual erosive and destructive polyarthritis, massive abdominal lymphadenopathy, asymptomatic central nervous system involvement, and rare manifestations of orbital pseudotumor and orchitis with epididymitis. Taking oral therapy with trimethoprim-sulfamethoxazole he had recurrent flares of orbital pseudotumor, an episode of orchitis with epididymitis, and persistent polymerase chain reaction T. whipplei-positive cerebrospinal fluid. Resolution was achieved with a one month course of intravenous ceftriaxone and a 6 month course of azithromycin, and no relapse occurred during 24 months of followup.