97th DOG Annual Meeting 1999



U. Schnurrbusch*, S. Keiner`, T. Friedrichº, K. Pittasch*

Introduction: Many people rapidly died because of malignant non-Hodgkin`s-lymphoma (NHL) until the introduction of CHOP-Scheme (Cyclophosphamid, Doxorubicin, Oncovin, Prednisolon). This NHL therapy has quite a high success rate from 50-60%. The death rate of patients with NHL is five times higher than in normal patients. Deaths occur also years after complete remission of primary tumor. Only 25-30% of patients survive more than 10 years. About 27% of them get recurrence.

Case report: This is a case of a 80-years old patient who has been castrated because of a centrocytic NHL of testicle. In addition a radio- and chemotherapy was following. After complete remission there were no hints of an other lymphoma in the next seven years. The patient was admitted with exophthalmus and a retrobulbar tumor with unknown dignity im December 1998. Ultrasound and computertomography were suspect of a tumor in the Fossa pterygopalatina. It is assumed that this is a recurrence of centrocytic NHL. The histologic diagnosis was a secundary centroblastic non-Hodgkin`s-lymphoma. The following chemotherapy started while the exophthalmus was in progress with insufficiency of lidclose and loss of visus from cc 0,8 to 1/15.

Discussion: Centrocytic NHL - like tumor diagnosed in the testicle in 1992 - are typical T-cell-Lymphomas (T-cell-and natural killer cell-neoplasia). They show a totally different descent and morphology than the retrobulbar localised centroblastic non-Hodgkin`s-lymphoma of that patient. So a secondary malignant lymphoma was postulated in that case. Only a few cases of occurence with two kinds of lymphoma in one patient are reported in the literature.

*Department of Ophthalmology, University Leipzig
` Department of Oto-Rhino-Laryngology, University Leipzig
ºDepartment of Pathology, University Leipzig