Case report reveals late pulmonary low-grade B-cell lymphoma following regressed choroidal lymphoid lesions in an older patient, highlighting the need for prolonged systemic surveillance.
Purpose: To report a case of indolent nonprogressive multifocal choroidal lymphoid lesions with late development of pulmonary low-grade B-cell lymphoma after lymphoid lesion regression. Methods: Case report. Results: A 79-year-old male was followed with ocular and systemic surveillance over a sixteen-year period for unilateral nonprogressive choroidal lesions presumed to be a benign lymphocytic disease of the choroid. Workups for systemic lymphoma and birdshot chorioretinopathy were negative. After sixteen years of observation, the choroidal lesions had largely regressed. Recent diagnosis of atrial fibrillation led to an incidental discovery of a right lower lobe lung lesion measuring 4.5 cm. Computerized tomography-guided biopsy showed low-grade B-cell lymphoma. There was no additional systemic disease detected. The patient underwent right lower lobectomy revealing extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue. Conclusion: Patients with indolent nonprogressive multifocal choroidal lymphoid lesions should be monitored regularly for late systemic disease, which although rare, can develop even after years of follow-up.
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Zandi et al. (2024) studied this question.