Limits...
T-cell lymphoma presenting as painful ophthalmoplegia.

Lee DS, Woo KI, Chang HR - Korean J Ophthalmol (2006)

Bottom Line: A metastatic workup was performed without any evidence of extraorbital tumor.The patient was recommended to be treated with chemotherapy, however, refused to take the treatment.The patient died of progression of the disease in a month.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT

Purpose: To present a case of peripheral T-cell lymphoma presenting as painful ophthalmoplegia.

Methods: A 61-year-old woman presented with a 2-week history of headache and eyeball pain. Examination showed mild exophthalmos, complete ophthalmoplegia, and ptosis of the left eye. Under the impression of nonspecific orbital inflammation, she was treated with oral prednisone with initial response. Two months later, she revisited the clinic with exacerbated symptoms. Anterior orbitotomy and incisional biopsy was performed for the inferior rectus muscle lesion.

Results: Histopathologic examination revealed an infiltrate of atypical lymphoid cells between degenerative muscle bundles. It was consistent with peripheral T-cell lymphoma. A metastatic workup was performed without any evidence of extraorbital tumor. The patient was recommended to be treated with chemotherapy, however, refused to take the treatment. The patient died of progression of the disease in a month.

Conclusions: T-cell lymphoma in the orbit can present as painful ophthalmoplegia and take a rapid clinical course. The disease should be regarded as one of the differential diagnosis for painful ophthalmoplegia refractory to corticosteroid therapy.

Show MeSH

Related in: MedlinePlus

The pictures show mild exophthalmos, erythematous, eyelid swelling, limited extraocular movement of the left side at initial presentation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2908846&req=5

Figure 1: The pictures show mild exophthalmos, erythematous, eyelid swelling, limited extraocular movement of the left side at initial presentation.

Mentions: A 61-year-old woman presented with a 2-week history of headache and left eyeball pain. She had no specific medical history or systemic disease. Visual acuity was 20/20 in both eyes. Intraocular pressure was 12/15 mmHg. There was 2-mm of proptosis and complete ptosis in the left eye. Extraocular movement was markedly limited in all directions of gaze in the left eye (Fig. 1). Anterior and posterior segment examination showed no specific abnormalities except conjunctival injection of the left eye. She had no lymphadenopathy. CT scan of the orbit showed a subtle enlargement of extraocular muscles in the left orbit (Fig. 2A). Under the impression of nonspecific orbital inflammation, she was treated with oral prednisone with initial response.


T-cell lymphoma presenting as painful ophthalmoplegia.

Lee DS, Woo KI, Chang HR - Korean J Ophthalmol (2006)

The pictures show mild exophthalmos, erythematous, eyelid swelling, limited extraocular movement of the left side at initial presentation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2908846&req=5

Figure 1: The pictures show mild exophthalmos, erythematous, eyelid swelling, limited extraocular movement of the left side at initial presentation.
Mentions: A 61-year-old woman presented with a 2-week history of headache and left eyeball pain. She had no specific medical history or systemic disease. Visual acuity was 20/20 in both eyes. Intraocular pressure was 12/15 mmHg. There was 2-mm of proptosis and complete ptosis in the left eye. Extraocular movement was markedly limited in all directions of gaze in the left eye (Fig. 1). Anterior and posterior segment examination showed no specific abnormalities except conjunctival injection of the left eye. She had no lymphadenopathy. CT scan of the orbit showed a subtle enlargement of extraocular muscles in the left orbit (Fig. 2A). Under the impression of nonspecific orbital inflammation, she was treated with oral prednisone with initial response.

Bottom Line: A metastatic workup was performed without any evidence of extraorbital tumor.The patient was recommended to be treated with chemotherapy, however, refused to take the treatment.The patient died of progression of the disease in a month.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT

Purpose: To present a case of peripheral T-cell lymphoma presenting as painful ophthalmoplegia.

Methods: A 61-year-old woman presented with a 2-week history of headache and eyeball pain. Examination showed mild exophthalmos, complete ophthalmoplegia, and ptosis of the left eye. Under the impression of nonspecific orbital inflammation, she was treated with oral prednisone with initial response. Two months later, she revisited the clinic with exacerbated symptoms. Anterior orbitotomy and incisional biopsy was performed for the inferior rectus muscle lesion.

Results: Histopathologic examination revealed an infiltrate of atypical lymphoid cells between degenerative muscle bundles. It was consistent with peripheral T-cell lymphoma. A metastatic workup was performed without any evidence of extraorbital tumor. The patient was recommended to be treated with chemotherapy, however, refused to take the treatment. The patient died of progression of the disease in a month.

Conclusions: T-cell lymphoma in the orbit can present as painful ophthalmoplegia and take a rapid clinical course. The disease should be regarded as one of the differential diagnosis for painful ophthalmoplegia refractory to corticosteroid therapy.

Show MeSH
Related in: MedlinePlus