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Non-secretory myeloma

Nickens CMN - MedPix (2007)

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Non-secretory myeloma

History: 62-year-old woman with a 5-month history of slowly progressive swelling and ptosis of the right upper eyelid. PMH: systemic hypertension VA: 20/25 in the affected eye 20/22 in the contralateral eye. IOP: 14 mmHg in both eyes. Ocular motility: restricted in all directions of gaze. Pupillary light reaction: preserved. Fundus examination: mild optic nerve head elevation and retinal venous congestion.

Findings: • A-B-scan: large, poorly defined, hypoechogenic tumour of the superior extraconal right orbit, with medium-low internal reflectivity. • Contrast-enhanced CT scan and MRI: bulky mass (30x21x34 mm) of the right orbit causing downward displacement of the globe and medial displacement of the superior rectus muscle and optic nerve. The lesion showed focal erosions of the orbital roof, without extension into the brain parenchyma. • Skull x-rays assessed changes in the bone structure with multiple punched-out lytic lesions, without sclerosis or periosteal reaction. Ocullar Pathology: Immunohistochemical stains positive for monoclonal light kappa chains, CD 138 (specific marker for plasma cells) proliferation index (Ki-67) 20%.

Ddx: • plasmocytoma • metastatic carcinoma • lymphoma and sarcoma.

Dxhow: Histological findings consistent with the diagnosis of plasmacytoma

Exam: On examination: slight exophthalmos with downward displacement of the RE, lid ptosis, upper lid poorly mobile infiltrative lesion fixed to adjacent tissues, no circumscribed mass.

No MeSH data available.


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Non-secretory myeloma

Nickens CMN - MedPix (2007)

© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1812&req=5

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Non-secretory myeloma

History: 62-year-old woman with a 5-month history of slowly progressive swelling and ptosis of the right upper eyelid. PMH: systemic hypertension VA: 20/25 in the affected eye 20/22 in the contralateral eye. IOP: 14 mmHg in both eyes. Ocular motility: restricted in all directions of gaze. Pupillary light reaction: preserved. Fundus examination: mild optic nerve head elevation and retinal venous congestion.

Findings: • A-B-scan: large, poorly defined, hypoechogenic tumour of the superior extraconal right orbit, with medium-low internal reflectivity. • Contrast-enhanced CT scan and MRI: bulky mass (30x21x34 mm) of the right orbit causing downward displacement of the globe and medial displacement of the superior rectus muscle and optic nerve. The lesion showed focal erosions of the orbital roof, without extension into the brain parenchyma. • Skull x-rays assessed changes in the bone structure with multiple punched-out lytic lesions, without sclerosis or periosteal reaction. Ocullar Pathology: Immunohistochemical stains positive for monoclonal light kappa chains, CD 138 (specific marker for plasma cells) proliferation index (Ki-67) 20%.

Ddx: • plasmocytoma • metastatic carcinoma • lymphoma and sarcoma.

Dxhow: Histological findings consistent with the diagnosis of plasmacytoma

Exam: On examination: slight exophthalmos with downward displacement of the RE, lid ptosis, upper lid poorly mobile infiltrative lesion fixed to adjacent tissues, no circumscribed mass.

No MeSH data available.