J Korean Ophthalmol Soc.  2008 Jul;49(7):1198-1202. 10.3341/jkos.2008.49.7.1198.

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

• Kim IT
• Park HY
• Roh YJ

• KMID: 1476979
• DOI: http://doi.org/10.3341/jkos.2008.49.7.1198

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.

Keyword

Adrenal lymphoma; Bilateral serous retinal detachment; Vogt-Koyanagi-Harada syndrome

MeSH Terms

Abdomen
Adrenal Glands
Drug Therapy, Combination
Eye
Female
Fever
Fluorescein Angiography
Headache
Humans
Lymphoma
Lymphoma, T-Cell
Middle Aged
Retinal Detachment
Thorax
Uveomeningoencephalitic Syndrome
Vision Disorders
Visual Acuity

Figure

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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.

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  Figure 2. Computed tomograph of the lower chest showing bilateral large adrenal mass suggesting lymphoma.

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  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.

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