Herrmann B, Rozot P, Baylac F, Civit T, Reynal C, Ketema M A
Service d'Ophtalmologie, Hôpital Notre-Dame de Bon-Secours, CHR Metz-Thionville.
J Fr Ophtalmol. 1996;19(12):780-4.
We present a case of orbital lipogranuloma with a supero-nasal retrobulbar localisation associated with axial proptosis and major choroidal thickening. No clinical sign of inflammation, neither orbital nor in the posterior segment, was revealed. The systemic work-up as well as paraclinical data were within normal limits. The diagnosis was made after histopathologic examination of the biopsy taken via superior orbit. Outcome was favorable following long-term systemic corticotherapy. Orbital lipogranuloma is a rare particular form of orbital pseudotumour of unknown etiology. It is characterized, histologically, by orbital fat necrosis. Pathogenesis remains controversial. The differential diagnosis includes iatrogenic lipogranulomas secondary to sinus surgery (paraffinoma), orbital granulomas in sarcoidosis and Wegener's disease and orbital lymphomas. The prognosis is usually good following treatment with steroids.
我们报告一例眶脂肪肉芽肿,病变位于球后鼻上方,伴有轴性眼球突出和脉络膜明显增厚。未发现眼眶及眼后段有炎症的临床体征。全身检查及辅助检查数据均在正常范围内。经眶上入路活检组织的组织病理学检查后作出诊断。长期全身皮质激素治疗后预后良好。眶脂肪肉芽肿是一种病因不明的罕见的特殊类型的眼眶假瘤。组织学上,其特征为眼眶脂肪坏死。发病机制仍存在争议。鉴别诊断包括鼻窦手术继发的医源性脂肪肉芽肿(石蜡瘤)、结节病和韦格纳肉芽肿中的眼眶肉芽肿以及眼眶淋巴瘤。使用类固醇治疗后预后通常良好。