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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.

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Related in: MedlinePlus

(A) The atypical lymphoid cells show irregular outlines with small inconspicuous nucleoli (H&E stain; ×400). (B) The cells are strongly positive for UCHL-1.
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Figure 3: (A) The atypical lymphoid cells show irregular outlines with small inconspicuous nucleoli (H&E stain; ×400). (B) The cells are strongly positive for UCHL-1.

Mentions: Histopathologically, atypical lymphoid infiltrates were present between scattered, degenerated muscular bundles. Atypical lymphocytes were small to medium sized with irregular nuclear outlines and inconspicuous nucleoli (Fig. 3A). They were strongly positive for T cell marker, UCHL-1, but negative for B cell marker, L26, immunohistochemically (Fig. 3B). Based on the histologic and immunophenotypic features, this tumor was consistent with peripheral T-cell lymphoma.


T-cell lymphoma presenting as painful ophthalmoplegia.

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

(A) The atypical lymphoid cells show irregular outlines with small inconspicuous nucleoli (H&E stain; ×400). (B) The cells are strongly positive for UCHL-1.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: (A) The atypical lymphoid cells show irregular outlines with small inconspicuous nucleoli (H&E stain; ×400). (B) The cells are strongly positive for UCHL-1.
Mentions: Histopathologically, atypical lymphoid infiltrates were present between scattered, degenerated muscular bundles. Atypical lymphocytes were small to medium sized with irregular nuclear outlines and inconspicuous nucleoli (Fig. 3A). They were strongly positive for T cell marker, UCHL-1, but negative for B cell marker, L26, immunohistochemically (Fig. 3B). Based on the histologic and immunophenotypic features, this tumor was consistent with peripheral T-cell lymphoma.

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