| Identifier |
walsh_2013_s1_c3-2 |
| Title |
Some Orbital Confusion |
| Creator |
Steven A. Newman, MD, University of Virginia School of Medicine, David T. Bourne |
| Subject |
Orbit; Marginal Zone Lymphoma; IGH-PCR; Immunohistochemistry |
| History |
In September 2006 he had been referred for a second opinion regarding a 5 year history of intermittent swelling around the right orbit, worsening over 7 months associated with double vision, and proptosis (C,D). |
| Pathology |
Review of the original orbital pathology failed to confirm malignancy and a repeat orbital biopsy was planned. |
| Disease/Diagnosis |
Persistent and recurrent low grade B cell lymphoma (marginal zone) demonstrated by gene rearrangement studies. |
| Clinical |
Acuity was 20/25. 24-2 demonstrated moderate diffuse depression OD > OS, and some arcuate VF changes OS. Palpebral fissures were 13 and 10 with an upper lid range of 15 and 12. Hertels 28/19 with some resistance to retropulsion. There was no APD, but definite limitation in elevation > abduction, adduction, and depression OD with 100 seconds stereopsis. Applanation tensions were 16 and 12. OCT demonstrated minimal thinning of NFL superiorly and nasally, but symmetric OU. CT scan (A,B) demonstrated R orbital pathology. |
| Presenting Symptom |
A 64 year old gentleman was referred for progressive horizontal diplopia. |
| Neuroimaging |
Flow Cytometry |
| Treatment |
Chlorambucil |
| Date |
2013-02 |
| References |
1. Coupland SE, Jaehne D, Hummel M, Stein H: The tale and molecular trail of a disseminated ocular adnexal malt lymphoma. Graefe's Arch Clin Exp Ophthalmol 2007;245:1055-59. 2. Dey P: Role of ancillary techniques in diagnosing and subclassifying non-Hodgkin's lymphomas on fine needle aspiration cytology. Cytopathology 2006; 17: 275-87. 3. McNally L, Jakobiec FA, Knowles DM: Clinical, morphologic, immunophenotypic, and molecular genetic analysis of bilateral ocular adnexal lymphoid neoplasms in 17 patients. Am J Ophthalmol 1987; 103: 555- 68. 4. Sjö,LD: Ophthalmic lymphoma: epidemiology and pathogenesis. Acta Ophthalmol 2009;87:1-20. 5. Venkatraman L, Catherwood MA, Patterson A. et al: Role of polymerase chain reaction and immunocytochemistry in the cytological assessment of lymphoid proliferations. J Clin Pathol 2006; 59: 160-5. |
| Language |
eng |
| Format |
video/mp4 |
| Type |
Image/MovingImage |
| Source |
45th Annual Frank Walsh Society Meeting |
| Relation is Part of |
Case presented at the NANOS 2013 Walsh Session, February 10 |
| Collection |
Neuro-Ophthalmology Virtual Education Library - Walsh Session Annual Meeting Archives https://novel.utah.edu/Walsh/index3.html |
| Publisher |
Spencer S. Eccles Health Sciences Library, University of Utah |
| Holding Institution |
Spencer S. Eccles Health Sciences Library, University of Utah, 10 N 1900 E SLC, UT 84112-6350 |
| Rights Management |
Copyright 2013. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright |
| ARK |
ark:/87278/s6dr5s1p |
| Setname |
ehsl_novel_fbw |
| ID |
179233 |
| Reference URL |
https://collections.lib.utah.edu/ark:/87278/s6dr5s1p |
