Iris pigment epithelial cysts in acute lymphoblastic leukemia-a case report
Background Iris cysts are classified as either primary or secondary, with further subcategorization based on the tissue of origin. The most common type is the primary iris pigment epithelial (IPE) cyst. We report a rare case of bilateral IPE cysts in a patient with acute lymphoblastic leukemia (AL...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | en |
| Published: |
BioMed Central Ltd
2025
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| Subjects: | |
| Online Access: | http://ir.unimas.my/id/eprint/50013/1/s12886-025-04419-8.pdf http://ir.unimas.my/id/eprint/50013/ https://bmcophthalmol.biomedcentral.com/articles/10.1186/s12886-025-04419-8 https://doi.org/10.1186/s12886-025-04419-8 |
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| Summary: | Background Iris cysts are classified as either primary or secondary, with further subcategorization based on the
tissue of origin. The most common type is the primary iris pigment epithelial (IPE) cyst. We report a rare case of
bilateral IPE cysts in a patient with acute lymphoblastic leukemia (ALL).
Case presentation A 3-year-old male toddler initially presented with signs and symptoms of anemia. Multiple
lymph nodes were palpable throughout the body, and hepatosplenomegaly was noted. An incidental finding of
cystic lesions at the margins of both pupils prompted referral to the ophthalmology team. There was no family
history of malignancy or similar eye conditions. Ophthalmic examination revealed IPE cysts in both eyes (BE). Fundus
examination showed a dull macula, and tortuous vessels, with no retinal hemorrhages observed. Intraocular pressure
was normal. Petechial rashes were present on both eyelids.
A full blood count revealed pancytopenia, and a peripheral blood film (PBF) showed a leucoerythroblastic picture
without obvious blast cells. Bone marrow aspiration and trephine biopsy (BMAT) were performed. Trephine biopsy
and bone marrow immunophenotyping were suggestive of B-cell acute lymphoblastic leukemia (B-cell ALL) with
aberrant CD58 expression. Cytogenetic analysis revealed hyperdiploidy, a favourable prognostic marker. The patient
was started on chemotherapy. Following initiation of chemotherapy, the IPE cysts decreased in size.
Conclusion In this case, the IPE cysts were likely associated with ALL. This rare occurrence may raise awareness of a potential link between IPE cysts and hematological malignancies, and could pave the way for future research to elucidate the underlying pathogenesis and treatment implications. |
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