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Clinical history
Middle-aged female with chronic ocular inflammation.
Diagnosis
Ocular/CNS large B cell lymphoma. There is extensive atrophy and degeneration of the retina. In areas one can find collections of lymphoma cells on the inner aspect of Bruchs membrane; in some areas it is apparent that the tumor cells are between the retinal pigment epithelium and Bruchs membrane. There are non-neoplastic lymphocytes in the adjacent choroid that serve to highlight the histologic differences between lymphoma cells and normal lymphocytes (lymphoma cells are larger and have hyperchromatic nuclei with apoptotic and associated necrotic debris). Typically these tumors do not invade or form tumors in the uveal tract, but this case is unusual because there is a prominent nodule of tumor in the ciliary body.
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