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Tae Kim, Young Park, and Young Jung: Bilateral Adrenal Gland Lymphoma Masquerading as Vogt-Koyanagi-Harada Syndrome
Original Article

J Korean Ophthalmol Soc 2008;49(7):1198-1202.

Published online: 7 September 2008

DOI: https://doi.org/10.3341/jkos.2008.49.7.1198

Bilateral Adrenal Gland Lymphoma Masquerading as Vogt-Koyanagi-Harada Syndrome

In Tae Kim, M.D., Hae Young Park, M.D., Roh Young Jung, M.D.

Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea

Address reprint requests to Young Jung Roh, M.D. Department of Ophthalmology, St. Mary's Hospital, The Catholic University of Korea #62 Yeouido-dong, Yeongdeungpo-gu, Seoul 150-713, Korea Tel: 82-2-3779-1848, Fax: 82-2-761-6869, E-mail: youngjungroh@hanmail.net

Received 23 April 2008       Accepted 21 January 2008

Copyright © 2015 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report a case of bilateral adrenal gland lymphoma mimicking symptoms of Vogt-Koyanagi- Harada syndrome.

Case summary

A 57-year-old woman complained of decreased visual acuity and metamorphopsia in both eyes. She had no prior medical history, but had experienced headaches in the past week. Fundus examination revealed multiple serous retinal detachment. Fluorescein angiography of the fundus revealed multiple pinpoint leaks in early stages and subretinal dye pooling in the retinal detachment area in late stages. The most likely diagnosis was therefore Vogt-Koyanagi-Harada syndrome. Two days later, mild fever developed and a systemic evaluation was performed. Computed tomography of chest and abdomen showed bilateral adrenal gland T-cell lymphoma. Through prompt combination chemotherapy, the patient’s systemic condition recovered, and her fundus recovered with improved visual acuity.

Conclusions

We experienced a rare case of bilateral adrenal lymphoma which masqueraded as Vogt-Koyanagi- Harada syndrome. When there are systemic symptoms such as mild fever and headaches, systemic evaluation should be done so as not to miss more serious systemic pathology.

Keywords: Adrenal lymphoma, Bilateral serous retinal detachment, Vogt-Koyanagi-Harada syndrome

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Figure 1.
Fundus photographs of the right eye (A) and left eye (B) showing multifocal serous retinal detachment in both eyes. Fluorescein angiographs of the right eye (C) and left eye (D) showing multiple pinpoint leaking and pooling of dye in the areas of neurosensory retinal detachment.
jkos-49-1198f1.tif
Figure 2.
Computed tomograph of the lower chest showing bilateral large adrenal mass suggesting lymphoma.
jkos-49-1198f2.tif
Figure 3.
Fundus photographs of the right eye (A) and left eye (B). Fluorescein angiographs of the right eye (C) and left eye (D) show flat retina without retinal elevation and dye leaking.
jkos-49-1198f3.tif
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