Limits...
Bilateral orbital mass lesions: a presentation of Wegener's granulomatosis.

Aletaha M, Tavakoli M, Kanavi MR, Hashemlou A, Roghaei S - J Ophthalmic Vis Res (2011)

View Article: PubMed Central - PubMed

Affiliation: Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Excisional biopsy of the left orbital mass through a Lynch incision was performed and the mass was completely removed (Fig. 4)... Histopathological examination of the specimen confirmed granulomatous vasculitis compatible with WG (Fig. 5)... Orbital involvement usually presents with proptosis, occasional pain, eyelid edema and limitation of ocular movements and is the most prevalent ocular involvement by WG... In a large 16-year survey, 140 patients with biopsy-proven WG were examined and orbital disease was reported as the most common ocular involvement in 15% of cases... Similar results have been reported by other authors., Orbital involvement usually present several years after the onset of the disease (as in our patient), however the ophthalmologist may be the first physician who faces a patient with WG... Therefore this condition should always be considered in patients with orbital mass lesions and chronic sinus disease., Orbital inflammatory disease in WG may develop as a result of primary granulomatous vasculitis or more commonly following extension of sinus involvement into the orbital cavity... Histopathological findings include the classic triad of vasculitis, granulomatous inflammation (with or without giant cells) and tissue necrosis; however, the full picture may not be seen in one specimen... In summary, WG should be considered in patients with uni- or bilateral localized orbital mass lesions especially those with underlying chronic paranasal sinus disease, with or without systemic involvement... Prompt treatment with potent immunosuppressive agents including cyclophosphamide is necessary to improve visual and systemic prognosis.

No MeSH data available.


Related in: MedlinePlus

Histopathological examination of the specimen shows evidence of granulomatous vasculitis: (A) Fibrotic and collagenized vascular tufts in which the lumens are occluded with infiltration of acute and chronic inflammatory cells within the collagenous stroma (Hematoxylin & Eosin, ×100). (B) Higher magnification shows occluded vascular lumens (arrows) surrounded by infiltration of inflammatory cells (Hematoxylin & Eosin, ×200). (C) Granulomatous inflammation accompanied by infiltration of Langhans cells, a variety of multinucleated giant cells (Hematoxylin & Eosin, ×200). (D) Small area of necrosis surrounded by acute inflammatory cells in the background stroma (Hematoxylin & Eosin, ×200). (E) Polymorphonuclear cells and eosinophils have infiltrated the vascular wall, compatible with vasculitis (arrow). The lumen of an occluded vessel is visible adjacent to the vasculitis on the left side of the image (asterisk) (Hematoxylin & Eosin, ×400). (F) Higher magnification of the vasculitis shown in figure E (Hematoxylin & Eosin, ×1000).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3306094&req=5

f5-jovr-6-3-215: Histopathological examination of the specimen shows evidence of granulomatous vasculitis: (A) Fibrotic and collagenized vascular tufts in which the lumens are occluded with infiltration of acute and chronic inflammatory cells within the collagenous stroma (Hematoxylin & Eosin, ×100). (B) Higher magnification shows occluded vascular lumens (arrows) surrounded by infiltration of inflammatory cells (Hematoxylin & Eosin, ×200). (C) Granulomatous inflammation accompanied by infiltration of Langhans cells, a variety of multinucleated giant cells (Hematoxylin & Eosin, ×200). (D) Small area of necrosis surrounded by acute inflammatory cells in the background stroma (Hematoxylin & Eosin, ×200). (E) Polymorphonuclear cells and eosinophils have infiltrated the vascular wall, compatible with vasculitis (arrow). The lumen of an occluded vessel is visible adjacent to the vasculitis on the left side of the image (asterisk) (Hematoxylin & Eosin, ×400). (F) Higher magnification of the vasculitis shown in figure E (Hematoxylin & Eosin, ×1000).

Mentions: Excisional biopsy of the left orbital mass through a Lynch incision was performed and the mass was completely removed (Fig. 4). Histopathological examination of the specimen confirmed granulomatous vasculitis compatible with WG (Fig. 5). Anti-inflammatory medications were continued. The rheumatologist recommended excisional biopsy of the right orbital mass as well, but the patient declined further intervention.


Bilateral orbital mass lesions: a presentation of Wegener's granulomatosis.

Aletaha M, Tavakoli M, Kanavi MR, Hashemlou A, Roghaei S - J Ophthalmic Vis Res (2011)

Histopathological examination of the specimen shows evidence of granulomatous vasculitis: (A) Fibrotic and collagenized vascular tufts in which the lumens are occluded with infiltration of acute and chronic inflammatory cells within the collagenous stroma (Hematoxylin & Eosin, ×100). (B) Higher magnification shows occluded vascular lumens (arrows) surrounded by infiltration of inflammatory cells (Hematoxylin & Eosin, ×200). (C) Granulomatous inflammation accompanied by infiltration of Langhans cells, a variety of multinucleated giant cells (Hematoxylin & Eosin, ×200). (D) Small area of necrosis surrounded by acute inflammatory cells in the background stroma (Hematoxylin & Eosin, ×200). (E) Polymorphonuclear cells and eosinophils have infiltrated the vascular wall, compatible with vasculitis (arrow). The lumen of an occluded vessel is visible adjacent to the vasculitis on the left side of the image (asterisk) (Hematoxylin & Eosin, ×400). (F) Higher magnification of the vasculitis shown in figure E (Hematoxylin & Eosin, ×1000).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3306094&req=5

f5-jovr-6-3-215: Histopathological examination of the specimen shows evidence of granulomatous vasculitis: (A) Fibrotic and collagenized vascular tufts in which the lumens are occluded with infiltration of acute and chronic inflammatory cells within the collagenous stroma (Hematoxylin & Eosin, ×100). (B) Higher magnification shows occluded vascular lumens (arrows) surrounded by infiltration of inflammatory cells (Hematoxylin & Eosin, ×200). (C) Granulomatous inflammation accompanied by infiltration of Langhans cells, a variety of multinucleated giant cells (Hematoxylin & Eosin, ×200). (D) Small area of necrosis surrounded by acute inflammatory cells in the background stroma (Hematoxylin & Eosin, ×200). (E) Polymorphonuclear cells and eosinophils have infiltrated the vascular wall, compatible with vasculitis (arrow). The lumen of an occluded vessel is visible adjacent to the vasculitis on the left side of the image (asterisk) (Hematoxylin & Eosin, ×400). (F) Higher magnification of the vasculitis shown in figure E (Hematoxylin & Eosin, ×1000).
Mentions: Excisional biopsy of the left orbital mass through a Lynch incision was performed and the mass was completely removed (Fig. 4). Histopathological examination of the specimen confirmed granulomatous vasculitis compatible with WG (Fig. 5). Anti-inflammatory medications were continued. The rheumatologist recommended excisional biopsy of the right orbital mass as well, but the patient declined further intervention.

View Article: PubMed Central - PubMed

Affiliation: Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Excisional biopsy of the left orbital mass through a Lynch incision was performed and the mass was completely removed (Fig. 4)... Histopathological examination of the specimen confirmed granulomatous vasculitis compatible with WG (Fig. 5)... Orbital involvement usually presents with proptosis, occasional pain, eyelid edema and limitation of ocular movements and is the most prevalent ocular involvement by WG... In a large 16-year survey, 140 patients with biopsy-proven WG were examined and orbital disease was reported as the most common ocular involvement in 15% of cases... Similar results have been reported by other authors., Orbital involvement usually present several years after the onset of the disease (as in our patient), however the ophthalmologist may be the first physician who faces a patient with WG... Therefore this condition should always be considered in patients with orbital mass lesions and chronic sinus disease., Orbital inflammatory disease in WG may develop as a result of primary granulomatous vasculitis or more commonly following extension of sinus involvement into the orbital cavity... Histopathological findings include the classic triad of vasculitis, granulomatous inflammation (with or without giant cells) and tissue necrosis; however, the full picture may not be seen in one specimen... In summary, WG should be considered in patients with uni- or bilateral localized orbital mass lesions especially those with underlying chronic paranasal sinus disease, with or without systemic involvement... Prompt treatment with potent immunosuppressive agents including cyclophosphamide is necessary to improve visual and systemic prognosis.

No MeSH data available.


Related in: MedlinePlus