Mottow-Lippa L, Jakobiec F A, Smith M
Ophthalmology. 1981 Jun;88(6):565-74. doi: 10.1016/s0161-6420(81)34984-7.
Twenty-nine patients with pediatric orbital pseudotumor underwent a wide variety of diagnostic tests including biopsies. The following abnormalities were discovered: peripheral blood eosinophilia (9/29 patients); elevated ESR (17/27); elevated antinuclear antibody titres in the Tolosa-Hunt variant (2/2); hypercomplementemia (2/3); and mild CSF pleocytosis (2/6). Thyroid function tests were normal in nine patients so studied. B-mode ultrasonography performed on 12 patients displayed abnormalities in all cases (some combination of Tenonitis, myositis, perioptic inflammation, or mass effect). Computed tomography in seven patients provided higher resolution confirmation of these findings. Orbital bone changes and serious sinus disease were absent on routine radiographic studies. Biopsies performed on 16 patients disclosed mild lymphocytic inflammation in all cases, fibrosis and tissue eosinophilia in 9 biopsies (6 correlating with peripheral blood eosinophilia). Nine biopsies demonstrated a lipogranulomatous response to damaged fat cells. A true vasculitis or extensive lymphoid hyperplasia was not identified in any biopsy specimen.
29例儿童眼眶假瘤患者接受了包括活检在内的多种诊断检查。发现了以下异常情况：外周血嗜酸性粒细胞增多（9/29例患者）；血沉升高（17/27）；托洛萨-亨特变异型中抗核抗体滴度升高（2/2）；补体血症（2/3）；以及轻度脑脊液淋巴细胞增多（2/6）。接受检查的9例患者甲状腺功能测试正常。对12例患者进行的B型超声检查在所有病例中均显示异常（包括一些巩膜外层炎、肌炎、视神经周围炎症或肿块效应的组合）。7例患者的计算机断层扫描提供了这些发现的更高分辨率确认。常规放射学检查未发现眼眶骨改变和严重鼻窦疾病。对16例患者进行的活检在所有病例中均显示轻度淋巴细胞炎症，9例活检显示纤维化和组织嗜酸性粒细胞增多（6例与外周血嗜酸性粒细胞增多相关）。9例活检显示对受损脂肪细胞的脂质性肉芽肿反应。在任何活检标本中均未发现真正的血管炎或广泛的淋巴样增生。
