A Case of Proptosis Associated with Orbital Panniculitis

ABSTRACT

PURPOSE: To report a case with proptosis associated with orbital panniculitis. METHODS: A 34-old-year man with unilateral proptosis for 1 month presented with diffuse swelling and redness in the eyelid and conjunctiva. His systemic symptoms were high fever, headache, nausea, diarrhea, dizziness, weight loss, malaise and hepatosplenomegaly. He had subcutaneous nodules on the inguinal region, the pubis, and the upper abdomen. Ophthalmic examinations, orbit magnetic resonance imaging(MRI), and biopsy from orbital tissue were performed. RESULTS: The right eye revealed proptosis(22/14/102, Hertel's exophthalmometer), but other ocular findings including the fundus were normal. Diffuse infilterative lesions and definite proptosis were shown on orbit MRI. Biopsy specimen of orbital tissue revealed histiocytes containing nuclei and nuclear debris, mononuclear cells infiltration, and the characteristic 'bean-bag' cell i.e., macrophage exhibiting hemophagocytosis, which is histopathological characteristic of cytophagic histiocytic panniculitis. Proptosis, swelling and redness of the eyelid improved gradually following systemic corticosteroid therapy to control the disease. CONCLUSION: This report describes a rare finding of proptosis as the manifesting sign of orbital panniculitis.