Histologic Findings in T-cell Lymphoma Infiltration of the Optic Nerve

Objective: To report the clinical and histologic features of lymphomatous infiltration of the optic nerve by systemic T-cell non-Hodgkin's lymphoma (NHL). Design: Interventional case report. Participant: A patient with peripheral T-cell NHL. Methods: A 39-year-old man with a diagnosis of peripheral T-cell NHL, stage IV, with CNS involvement and decreased vision was found to have lymphomatous infiltration of the optic nerves. Main Outcome Measure: Visual acuity. Results: Despite treatment with chemotherapy and an optic nerve sheath fenestration, the patient lost vision in the right eye and subsequently underwent an optic nerve biopsy. The histopathology showed diffuse infiltration with a clonal population of lymphocytic cells that were CD3 positive and CD20 negative, consistent with T-cell NHL. Conclusion: Optic nerve infiltration from systemic B-cell lymphoma is rare and has been reported; we report an unusual case of bilateral optic nerve infiltration secondary to peripheral T-cell NHL.