Hsu Min-Wen, Chung Chia-Hung, Chang Cheng-Hsien, Hu Pei-Shin, Hsu Shiuh-Liang
Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Kaohsiung J Med Sci. 2006 Apr;22(4):194-8. doi: 10.1016/S1607-551X(09)70307-9.
Ptosis on its own is an infrequent initial manifestation of orbital lymphoma. Orbital lymphoma usually presents as a palpable mass with proptosis, diplopia, and conjunctival ("salmon-pink") swelling. We report here a 62-year-old female patient who presented with right eye ptosis. The initial imaging study showed an indistinct enlargement of the superior rectus-levator muscle complex. After 3-4 months, ptosis and upward gazing movement were further restricted. The imaging study revealed a definite soft-tissue mass in the superior orbit surrounding the superior rectus-levator muscle complex. A tumor biopsy through anterior orbitotomy revealed a large diffuse B-cell lymphoma. With the experience of this case, we suggest that orbital lymphoma should be included in the differential diagnosis of ptosis accompanied by impairment of levator muscle function.
上睑下垂本身是眼眶淋巴瘤罕见的初始表现。眼眶淋巴瘤通常表现为可触及的肿块，并伴有眼球突出、复视和结膜（“鲑鱼粉红色”）肿胀。我们在此报告一名62岁女性患者，其表现为右眼上睑下垂。初始影像学检查显示上直肌-提上睑肌复合体有模糊的肿大。3至4个月后，上睑下垂和向上注视运动进一步受限。影像学检查显示在上眼眶围绕上直肌-提上睑肌复合体有明确的软组织肿块。通过前路眼眶切开术进行的肿瘤活检显示为弥漫性大B细胞淋巴瘤。基于该病例的经验，我们建议眼眶淋巴瘤应纳入伴有提上睑肌功能障碍的上睑下垂的鉴别诊断。
