Diagnosis of Secondary Vitreoretinal Lymphoma With Neurosurgical Stereotactic Biopsy: A Multimodal Diagnostic and Imaging Approach

Abstract

Purpose: To describe an atypical diagnostic approach with multimodal imaging analysis in a patient with primary testicular lymphoma who experienced secondary vitreoretinal recurrence. Methods: A single case was evaluated. Results: A complete ophthalmologic examination, including optical coherence tomography (OCT), fluorescein angiography (FA), fundus autofluorescence (FAF), neuroimaging, and stereotactic biopsy, was performed. A dilated fundus examination showed bilateral white subretinal lesions with pinpoint hyperfluorescence on FA and central hypoautofluorescence with peripheral hyperautofluorescence on FAF. OCT revealed bilateral subretinal hyperreflective material. Magnetic resonance imaging of the brain revealed a 7 mm contrast-enhancing lesion of the right thalamus. Following a negative diagnostic vitrectomy, subsequent stereotactic biopsy of the lesion confirmed recurrent lymphoma. Conclusions: This case emphasized the importance of using multidisciplinary methods to confirm a diagnosis of secondary vitreoretinal lymphoma and allowed an appropriate treatment plan to be made.