Eyelid Swelling and Proptosis with Systemic Implications

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Presentation transcript:

Eyelid Swelling and Proptosis with Systemic Implications Shaza N. Al-Holou, MD, Victor M. Elner, MD, PhD, Raymond S. Douglas, MD, PhD, Shannon S. Joseph, MD, MSc The American Journal of Medicine Volume 129, Issue 7, Pages e51-e53 (July 2016) DOI: 10.1016/j.amjmed.2016.01.027 Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 1 Swelling and erythema of the left upper eyelid. There was also moderate conjunctival injection and mild chemosis. The lacrimal gland was enlarged and palpable. The American Journal of Medicine 2016 129, e51-e53DOI: (10.1016/j.amjmed.2016.01.027) Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 2 Orbital computed tomography (CT) scan with contrast (left top and left bottom) reveals left orbital soft tissue swelling most pronounced in the superior and lateral aspect of the lacrimal gland with increased contrast enhancement. Neck CT (right) demonstrates numerous mildly enhancing lymph nodes in neck and parotid gland. The American Journal of Medicine 2016 129, e51-e53DOI: (10.1016/j.amjmed.2016.01.027) Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 3 Histopathology of left lacrimal gland biopsy. Photomicrograph of lacrimal gland biopsy shows chronic dacryoadenitis, a lymphoepithelial lesion, and infiltration of ductal epithelium by lymphocytes. H&E stain, 200× magnification. The American Journal of Medicine 2016 129, e51-e53DOI: (10.1016/j.amjmed.2016.01.027) Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 4 Histopathology of salivary gland biopsy. The salivary gland biopsy shows lymphocytic infiltrates surrounding ductal epithelium and acini with focus score of 2. H&E stain, 200× magnification. The American Journal of Medicine 2016 129, e51-e53DOI: (10.1016/j.amjmed.2016.01.027) Copyright © 2016 Elsevier Inc. Terms and Conditions