CLL Case 4
Fluorescein Angiography 12-00 to 4-01
Subject: CLL Case
Date: June 28th 2001
From: Gonzalo Blanco (Spain)
Dear List Members:
We have a difficult case and would like to get your comments on treatment.
Subject: CLL Case
Date: June 28th 2001
From: Gonzalo Blanco (Spain)
Dear List Members:
We have a difficult case and would like to get your comments on treatment.
Case 1
An elderly woman with a past medical history of CLL came to our attention during a certain period of hematological remission of CLL, and without coagulation problems. She presented with subretinal hemorrhages in 4 quadrants of her left eye. There was no venous tortuosity. Fluorescein angiography showed a hyperfluorescent extrafoveal lesion. This lesion was hyperfluorescent in the late phases of the angiogram. |
Q & A with ECN Members From: James P. Bolling, M.D. responds 6-29-01 Q: What additional examinations should be performed to determine the origin of the lesion? A: Gadolinium enhanced MR of the head, ICG Q: It could be possible that during a period of an hematological remission, the CLL can relapse as an isolated lesion? A: Yes, but this lesion looks more like focal chorioretinitis and choroidal neovascularization. The vitreous looks clear (judging from the photographs) and the B-scan looks like sub-retinal fluid not a mass. Q: Do you think it is possible that this lesion could be Richter Syndrome? A: I don't think this is Lymphoma based on the information given. Q: Which is the most appropriate local treatment in this case? A: Observation Q: Is plaque radiation therapy indicated for recurrent CLL? A: No external beam radiation is usually sufficient. From Alain Rousseau, MD (Quebec, Canada) responds 7-4-01: |
I agree with what has been suggested at the end of the case presentation. Very interesting case, it could very well be 2 different diseases, would like to be informed of the outcome.
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