{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T16:19:45Z","timestamp":1778948385192,"version":"3.51.4"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:00:00Z","timestamp":1760659200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:00:00Z","timestamp":1760659200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100008127","name":"Universiti Malaysia Sarawak","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100008127","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Ophthalmol"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>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).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Case presentation<\/jats:title>\n            <jats:p>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.<\/jats:p>\n            <jats:p>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.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>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.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12886-025-04419-8","type":"journal-article","created":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T13:10:25Z","timestamp":1760706625000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Iris pigment epithelial cysts in acute lymphoblastic leukemia-a case report"],"prefix":"10.1186","volume":"25","author":[{"given":"Kar Yong","family":"Chong","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong Zheng","family":"Wai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nurhayati","family":"Abdul Kadir","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lik Thai","family":"Lim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raja Muhamad","family":"Zul Hatta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wai Seng","family":"Chiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,10,17]]},"reference":[{"key":"4419_CR1","first-page":"771","volume":"79","author":"JA Shields","year":"1981","unstructured":"Shields JA. 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Primary cysts of the iris pigment epithelium clinical features and natural course in 234 patients. Ophthalmology. 1998. https:\/\/doi.org\/10.1016\/S0161-6420(98)91034-X.","journal-title":"Ophthalmology"},{"issue":"19","key":"4419_CR5","doi-asserted-by":"publisher","first-page":"3499","DOI":"10.1200\/JCO.22.01760","volume":"41","author":"M Campbell","year":"2023","unstructured":"Campbell M, Kiss C, Zimmermann M, et al. Childhood acute lymphoblastic leukemia: results of the randomized acute lymphoblastic leukemia Intercontinental-Berlin-Frankfurt-M\u00fcnster 2009 trial. J Clin Oncol. 2023;41(19):3499\u2013511. https:\/\/doi.org\/10.1200\/JCO.22.01760.","journal-title":"J Clin Oncol"},{"issue":"7","key":"4419_CR6","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1038\/sj.eye.6701308","volume":"18","author":"T Sharma","year":"2004","unstructured":"Sharma T, Grewal J, Gupta S, Murray PI. Ophthalmic manifestations of acute leukaemias: the ophthalmologist\u2019s role. 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No ethics approval is needed for this case report after a review by the committee of National Medical Research Registry. Written informed consent had been obtained from the patient\u2019s legal guardian for participation. We confirm that this study was conducted in full compliance with the principles of Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the parent of the patient for publication of this report and the accompanying images.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"582"}}