Guerriero S, Giancipoli G, Sborgia A, Fiore M G, Rossi R, Piscitelli D
Department of Ophthalmology and ORL, University of Bari, Italy.
Orbit. 2011 Jan;30(1):30-3. doi: 10.3109/01676830.2010.535645.
A 65-year-old woman presented with a long standing, progressive exophthalmos of the right eye. Her medical history was significant for Churg Strauss syndrome, and was treated with immunosuppressive therapy. She had undergone two previous orbital biopsies showing inflammatory reactive lymphoid hyperplasia. A diagnosis of orbital inflammation in Churg-Strauss syndrome was suspected, and the immunosuppressive therapy was increased. Because of the lack of response to therapy, a further biopsy was performed, by lateral orbitotomy approach. Biopsy of the mass revealed a granular cell tumor composed of S-100 positive cells with an acidophilic granular cytoplasm and peripheral lymphocytic infiltration. A granular cell tumor, which is very rare in the orbit, should be considered in the differential diagnosis of orbital tumors, and if suspected, an excisional biopsy must be undertaken. Typical histopathological aspect of the granular cell tumor is characterized by the presence of S-100 positive closely packed polygonal cells with a granular cytoplasm.
一名65岁女性因右眼长期进行性眼球突出就诊。她有显著的变应性肉芽肿性血管炎病史，曾接受免疫抑制治疗。她之前曾接受过两次眼眶活检，显示为炎症反应性淋巴组织增生。怀疑为变应性肉芽肿性血管炎相关的眼眶炎症，遂增加免疫抑制治疗剂量。由于治疗无反应，通过外侧眶切开术进一步活检。肿物活检显示为颗粒细胞瘤，由S-100阳性细胞组成，胞质嗜酸性颗粒状，周围有淋巴细胞浸润。颗粒细胞瘤在眼眶非常罕见，在眼眶肿瘤的鉴别诊断中应予以考虑，若怀疑该病，必须进行切除活检。颗粒细胞瘤典型的组织病理学表现为紧密排列的S-100阳性多边形细胞，胞质呈颗粒状。
