Presumptive primary intraocular lymphoma presented as an intraocular mass involving the optic nerve head

Primary intraocular lymphoma (PIOL) is a subset of primary central nervous system (CNS) lymphoma which initially presents in the eye with or without simultaneous CNS involvement (1). It is considered a variant of extranodal, non-Hodgkin lymphoma that is usually of an aggressive diffuse large B cell type (1–3). Diagnosis of PIOL requires histopathologic evidence of malignant lymphoma cells in brain biopsy, vitreous or CSF specimen (1, 2). Cytological examination is the mainstay method to detect lymphomatous cells (3, 4). Other ancillary tests like flow cytometry, immunohistochemistry staining, cytokine analysis, and gene rearrangement studies also aid in the diagnosis and further classification of PIOL (1, 4). Optic nerve and optic disc involvement may occur in the PIOL (4, 5). Here, we report a case with an unusual presentation of this malignancy presented as an intraocular mass with involvement of the optic nerve head. Case report