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Deschamps et al. TEACHING NEUROIMAGES NEUROLOGY RESIDENT AND FELLOW SECTION A 54-year-old man with eyelid swelling and diplopia.

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Presentation on theme: "Deschamps et al. TEACHING NEUROIMAGES NEUROLOGY RESIDENT AND FELLOW SECTION A 54-year-old man with eyelid swelling and diplopia."— Presentation transcript:

1 Deschamps et al. TEACHING NEUROIMAGES NEUROLOGY RESIDENT AND FELLOW SECTION A 54-year-old man with eyelid swelling and diplopia.

2 Deschamps et al. A 54-year-old man with a 5-year history of painless bilateral eyelid swelling proptosis diplopia Symptoms resolved with steroids but patient relapsed during tapering.

3 Deschamps et al.

4 IgG4-related orbital disease and enlargement of the trigeminal nerve branches Biopsy from the left infraorbital canal: Lymphoplasmacytic infiltrate and fibrosis with numerous plasma cells stained positive for IgG4 (arrows). Mean number of IgG4+ cells was 155 per high-power fields and ratio of IgG4+/IgG+ cells 89%. Serum IgG4 concentration was 878 mg/dl (normal range 4-86 mg/dl). Deschamps et al. IgG4-related disease is characterized by IgG4-positive cells and lymphocyte infiltration into various organs, including orbital tissues.

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