Kumar Sushil, Das Sima, Goyal J L, Chauhan D, Sangit V
Guru Nanak Eye Centre, New Delhi, India.
Int Ophthalmol. 2005 Dec;26(6):235-7. doi: 10.1007/s10792-007-9037-x. Epub 2007 Feb 16.
A 32-year-old lady presented with bilateral painful proptosis and left infranuclear facial palsy. She was mildly anemic. Ocular examination revealed a firm non-tender mass in the super lateral quadrant of both orbits. Fine-needle aspiration cytology from the orbital mass showed the presence of lymphoplasmacytoid cells. Bone marrow aspiration also showed the presence of similar cells. An IgM monoclonal gammopathy was seen on serum protein electrophoresis. A diagnosis of Waldenstrom's macroglobulinemia was made on the basis of these findings. Hyperviscosity retinopathy is the most commonly reported ocular abnormality in Waldenstrom's macroglobulinemia. Orbital tumor formation and cranial nerve palsies are rarely reported in this condition. We describe the first case of Waldenstrom's macroglobulinemia presenting as an isolated orbital mass and facial nerve palsy.
一名32岁女性出现双侧疼痛性眼球突出及左侧核下性面瘫。她有轻度贫血。眼部检查发现双侧眼眶外上象限有一个质地硬、无压痛的肿块。眼眶肿块的细针穿刺细胞学检查显示存在淋巴浆细胞样细胞。骨髓穿刺也显示存在类似细胞。血清蛋白电泳显示有IgM单克隆丙种球蛋白病。基于这些发现，诊断为华氏巨球蛋白血症。高黏滞度视网膜病变是华氏巨球蛋白血症最常报道的眼部异常。在这种情况下，眼眶肿瘤形成和颅神经麻痹很少见报道。我们描述了首例以孤立性眼眶肿块和面神经麻痹表现的华氏巨球蛋白血症病例。
