Tai Evelyn, Sim See Khim, Haron Juhara, Wan Hitam Wan-Hazabbah
Department of Ophthalmology, University Sains Malaysia - Health Campus, Kubang Kerian, Malaysia.
Department of Radiology, Hospital Sultanah Bahiyah, Alor Setar, Malaysia.
BMJ Case Rep. 2017 Aug 7;2017:bcr-2017-220895. doi: 10.1136/bcr-2017-220895.
Orbital involvement in multiple myeloma is unusual. We describe the case of an 85-year-old woman who presented with right eye proptosis, reduced visual acuity and diplopia. Computed tomography showed a lobulated, enhancing soft tissue mass arising from the right greater wing of the sphenoid with intraconal, lacrimal gland and ocular muscle involvement. Histopathology revealed predominantly atypical plasma cells in a background of reactive lymphocytes, with monoclonality towards kappa light chain protein, suggestive of multiple myeloma. This case illustrates the diagnostic imaging challenge of orbital multiple myeloma.
眼眶受累于多发性骨髓瘤并不常见。我们描述了一例85岁女性患者，她表现为右眼突出、视力下降和复视。计算机断层扫描显示，一个分叶状、强化的软组织肿块起源于右侧蝶骨大翼，累及肌锥内、泪腺和眼肌。组织病理学显示，在反应性淋巴细胞背景中主要为非典型浆细胞，对κ轻链蛋白呈单克隆性，提示为多发性骨髓瘤。该病例说明了眼眶多发性骨髓瘤的诊断性影像学挑战。
