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以眼部病變為初期徵候之復發性白血病―兩病例報告
Ophthalmic Manifestations as the First Evidence of Recurrence of Leukemia-Two Cases Report
摘要
約百分之五十之白血病可能波及眼部，但多為隱藏性。惡性細胞之直接眼球浸潤則少在臨床上觀察到。吾人報告兩例白血病患，以眼部病變為其復發之初期表徵。病例一為23歲男性，罹患急性淋巴性白血病，在疾病緩解數月復出現右眼視神經附近之白血細胞浸潤及兩眼之視乳頭水腫。病變在化學治療及放射線治療後消失。病例二為10歲女孩，罹患慢性骨髓性白血病併急性淋巴球白血病危象。經化學治療達到全身性緩解後出現偽前房蓄膿，眼壓增高。前房細胞學檢查證實惡性細胞浸潤。此兩例顯示眼科醫生之檢查在此病診斷及治療之重要性。
關鍵字
無資料並列摘要
Leukemia may be associated with some form of ocular involvement in about fifty percent of cases. However, it is uncommon to observe direct intraocular leukemic infiltration. We presented two cases of leukemia in whom the intraocular manifestations were the first evidence of recurrence of the disease. Case one was a 23-yerar-old male with the diagnosis of acute lymphoblastic leukemia. The patient complained of blurred vision a few months after complete remission. Ophthalmic findings revealed juxtapapillary leukemic infiltration in the left eye and disc edema in the right eye. The lesions disappeared after radiotherapy and chemotherapy. The other case was a 10-year-old girl with the diagnosis of chronic leukemia with acute blastic crisis. Pseudohypopyon developed a few months after systemic remission. Cytology from the anterior chamber fluid revealed leukemic cells. Subsequently, bilateral papilledema with leukemic infiltration of the central nervous system developed. Ophthalmologists may play an important role in the diagnosis and management of these life threatening diseases.
延伸閱讀
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