Department of Ophthalmology, Suny Downstate Medical Center. Brooklyn, New York, USA.
Department of Pathology, Suny Downstate Medical Center, Brooklyn, New York, USA.
Orbit. 2023 Aug;42(4):450-454. doi: 10.1080/01676830.2022.2034170. Epub 2022 Feb 28.
Intravascular large B-cell lymphoma (IVLBCL) is a rare type of lymphoma, involving the lumen of predominantly small blood vessels, especially capillaries. The orbit is an uncommon site of involvement for IVLBCL, and diagnosis before autopsy is even more rare as most cases are established post-mortem. Herein, the authors describe a 73-year-old male who presented with 3 weeks of progressive bilateral ptosis and ophthalmoplegia. Computed tomography (CT) and subsequent magnetic resonance imaging (MRI) revealed diffuse abnormal thickening and enhancement of bilateral orbital apices, superior orbital fissures, and cavernous sinus, along with persistent focal opacification of the left frontal and ethmoid sinuses. Infectious and inflammatory workup of serum and cerebrospinal fluid was negative. Ethmoidal sinus and middle turbinate biopsy confirmed intravascular large B-cell lymphoma and the patient was started on R-CHOP chemotherapy regimen.
血管内大 B 细胞淋巴瘤（IVLBCL）是一种罕见的淋巴瘤，主要累及小血管（尤其是毛细血管）的管腔。眼眶是 IVLBCL 的罕见受累部位，在尸检前做出诊断更为罕见，因为大多数病例是在死后确定的。在此，作者描述了一名 73 岁男性，他因进行性双侧上睑下垂和眼肌麻痹就诊，病程为 3 周。计算机断层扫描（CT）和随后的磁共振成像（MRI）显示双侧眶尖、眶上裂和海绵窦弥漫性异常增厚和强化，同时左侧额窦和筛窦持续存在局灶性不透明。血清和脑脊液的感染和炎症检查均为阴性。筛窦和中鼻甲活检证实为血管内大 B 细胞淋巴瘤，患者开始接受 R-CHOP 化疗方案。
