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
2013-02-10
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
Spencer S. Eccles Health Sciences Library, University of Utah
Holding Institution
North American Neuro-Ophthalmology Association (NANOS), Copyright 2013. For further information regarding the rights to this collection, please visit http://library.med.utah.edu/NOVEL