Unusual orbital lymphoma undetectable by magnetic resonance imaging: a case report.

Journal of Medical Case Reports
Maria TatsugawaHideharu Funatsu

Abstract

We report the case of a patient with orbital malignant lymphoma that was not detected by imaging studies when she presented with impaired vision, which lead to her eventual loss of sight. A 71-year-old Japanese woman complained of deteriorating vision in her left eye. On examination, papilledema was detected, but magnetic resonance imaging only showed slight thickening and enhancement of the left optic nerve. A diagnosis of idiopathic optic neuritis was made and corticosteroid pulse therapy was administered. During the next four months, the patient received a total of four courses of corticosteroid pulse therapy, but she still suffered from bilateral loss of vision. A second magnetic resonance imaging procedure revealed tumors in both orbits and a biopsy showed diffuse large B-cell malignant lymphoma. The possibility of malignant lymphoma should be considered in patients with recurrent optic neuropathy despite administration of corticosteroid pulse therapy, even when there are no abnormalities on cerebrospinal fluid examination or magnetic resonance imaging.

Citations

Nov 26, 2015·Journal français d'ophtalmologie·A Gavard-PerretP-Y Robert
May 20, 2015·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Dickson WongJo-Anne Pon

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Methods Mentioned

BETA
biopsy

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