Intraocular Myeloma

Abstract

An eighty-seven year old female presented with complaints of pain in the left eye. She had a history of chronic open angle glaucoma that was under control with medication. She had lost all vision, and the eye had become very painful and inflamed. She was admitted with a diagnosis of endopthalmitis. Enucleation was performed and inspection of the specimen revealed a firm globe with a white mass extending over the iris and across the pupil in the anterior chamber. Microscopic evaluation with the hematoxylin and eosin stain revealed a plasma cell infiltrate involving the ciliary process, extending into the posterior chamber, occlusion of the retinal artery, and extensive loss of nerve fibers within the optic nerve. An accumulation of a pinkish and somewhat fibrillar material within the tumor and optic nerve was also observed. Stains for myelin and amyloid and a methyl green pyronine were performed, and immunoperoxidase for IgG, IgA, IgM, kappa and lambda.