Meyer J H, Scharf B, Gerling J
University Eye Clinic, Freiburg, Germany.
Graefes Arch Clin Exp Ophthalmol. 1996 Feb;234(2):137-9. doi: 10.1007/BF00695254.
Lethal midline granuloma usually presents with rhinorrhoea and redness of the skin above the nose. Early ocular symptoms are very rare. We here describe a patient who presented with acute orbital cellulitis.
A 73-year-old woman had a 24-h history of severe pain around her left eye. We saw the typical clinical picture of orbital cellulitis. A CT scan revealed a diffuse infiltration of the left upper and lower lid, the anterior orbit and the ethmoidal sinuses.
On surgical exploration we found a granular, partly necrotic tumour. Histological examination revealed an angiocentric nasal T-cell lymphoma (midline granuloma).
Midline granuloma should be included in the differential diagnosis of acute orbital cellulitis.
