ABSTRACT
A 55-year-old obese Mexican American male with a 3-year history of adult-onset asthma presented with a 10-year history of disfiguring eyelid edema. A biopsy revealed lymphoid aggregates consisting of reactive lymphoid follicles and Touton giant cells. He was diagnosed with adult-onset asthma associated with periocular xanthogranuloma and treated with systemic steroids. This case highlights an uncommon disease in its most severe presentation.
Subject(s)
Asthma/complications , Necrobiotic Xanthogranuloma/complications , Orbital Diseases/complications , Administration, Oral , Asthma/diagnosis , Asthma/drug therapy , Edema/complications , Edema/diagnosis , Edema/drug therapy , Eyelid Diseases/complications , Eyelid Diseases/diagnosis , Eyelid Diseases/drug therapy , Humans , Male , Middle Aged , Necrobiotic Xanthogranuloma/diagnostic imaging , Necrobiotic Xanthogranuloma/drug therapy , Orbital Diseases/diagnostic imaging , Orbital Diseases/drug therapy , Prednisolone/therapeutic use , Tomography, X-Ray ComputedABSTRACT
The authors report a case of orbital plasmacytoma in a 48-year-old man with known multiple myeloma. He presented with proptosis, diplopia, and decreased vision of the left eye for several weeks. He had been previously treated for IgA lambda multiple myeloma with chemotherapy, radiation, and autologous stem cell transplant. After a left orbitotomy, flow cytometry revealed a tumor rich in plasma cells expressing CD138 with equivocal lambda light chain expression. The patient underwent orbital radiation, with improvement of vision and disc edema OS. The patient is currently undergoing salvage chemotherapy for relapse of multiple myeloma. This is the third reported case of IgA myeloma involving the orbit.
Subject(s)
Hypergammaglobulinemia/pathology , Immunoglobulin A , Multiple Myeloma/pathology , Orbital Neoplasms/pathology , Plasmacytoma/pathology , Combined Modality Therapy , Flow Cytometry , Humans , Hypergammaglobulinemia/immunology , Hypergammaglobulinemia/therapy , Immunoglobulin lambda-Chains/immunology , Magnetic Resonance Imaging , Male , Middle Aged , Multiple Myeloma/immunology , Multiple Myeloma/therapy , Orbital Neoplasms/immunology , Orbital Neoplasms/therapy , Plasma Cells/immunology , Plasma Cells/pathology , Plasmacytoma/immunology , Plasmacytoma/therapy , Proto-Oncogene Proteins c-bcl-2/metabolism , Syndecan-1/metabolism , Tomography, X-Ray ComputedABSTRACT
Idiopathic intracranial hypertension, also known as pseudotumor cerebri, is a condition of increased intracranial pressure without the presence of mass lesions and with normal cerebrospinal fluid composition. Patients may experience papilledema and vision loss. Optic nerve sheath fenestration (ONSF) is one method of stabilizing visual function and decreasing optic nerve edema. The authors report on 10 patients who underwent bilateral ONSF and in whom visual function was stable or improved postoperatively. The results obtained in these cases suggest that ONSF plays a role in visual preservation in idiopathic intracranial hypertension patients in the acute setting.
Subject(s)
Ophthalmologic Surgical Procedures/methods , Pseudotumor Cerebri/surgery , Vision Disorders/prevention & control , Adolescent , Adult , Child , Female , Humans , Male , Middle Aged , Optic Nerve/surgery , Pseudotumor Cerebri/complications , Vision Disorders/etiologySubject(s)
Leukemia-Lymphoma, Adult T-Cell/complications , Papilledema/etiology , Child , Humans , Male , Papilledema/pathology , RecurrenceABSTRACT
OBJECTIVE: To illustrate a newly recognized histopathologic change in a patient with canalicular obstruction after weekly administration of 5-fluorouracil for colon cancer. DESIGN: Interventional case report. METHODS: A full-thickness section of canaliculus was obtained during surgical repair. MAIN OUTCOME MEASURE: Histopathologic changes in the specimen. RESULTS: The prominent histologic feature of the canalicular specimen was severe squamous metaplasia with narrowing of the lumen. CONCLUSION: Canalicular obstruction may follow systemic use of 5-fluorouracil due to squamous metaplasia.
