Anterior Chamber Cytology Confirms the Diagnosis of T-cell Prolymphocytic Leukemia Masquerading as Viral Retinal Necrosis

ABSTRACT

Purpose

To describe a case of T-cell prolymphocytic leukemia (T-PLL) masquerading as viral retinal necrosis (VRN).

Case presentation

A 75-year-old-man with a history of T-PLL in complete remission complained of an acute vision loss in his right and only eye. Ophthalmic examination demonstrated the presence of anterior chamber cells, mild vitritis, and peripheral retinal whitening with intraretinal hemorrhages evocative of VRN. While the anterior chamber tap came back negative for HSV, VZV, and CMV, cytology performed on the aqueous humor described the presence of leukemic cells.

Conclusion

T-PLL can rarely masquerade as a viral retinal necrosis. Diagnostic work-up should therefore always rule out the infectious causes of retinitis. Anterior chamber tap can sometimes prove useful in the diagnosis of T-PLL even in the absence of a hypopyon, avoiding the need for vitrectomy.

KEYWORDS:

• Retinitis
• T-cell prolymphocytic leukemia
• uveitis
• vasculitis
• viral retinal necrosis

Patient consent

Oral consent was collected before the submission. This report does not contain any personal information that could lead to the identification of the patient.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The author(s) reported that there is no funding associated with the work featured in this article.