T-cell lymphoma presenting as painful ophthalmoplegia.
OBJECTIVE
To present a case of peripheral T-cell lymphoma presenting as painful ophthalmoplegia.


METHODS
A 61-year-old woman presented with a 2-week history of headache and eyeball pain. Examination showed mild exophthalmos, complete ophthalmoplegia, and ptosis of the left eye. Under the impression of nonspecific orbital inflammation, she was treated with oral prednisone with initial response. Two months later, she revisited the clinic with exacerbated symptoms. Anterior orbitotomy and incisional biopsy was performed for the inferior rectus muscle lesion.


RESULTS
Histopathologic examination revealed an infiltrate of atypical lymphoid cells between degenerative muscle bundles. It was consistent with peripheral T-cell lymphoma. A metastatic workup was performed without any evidence of extraorbital tumor. The patient was recommended to be treated with chemotherapy, however, refused to take the treatment. The patient died of progression of the disease in a month.


CONCLUSIONS
T-cell lymphoma in the orbit can present as painful ophthalmoplegia and take a rapid clinical course. The disease should be regarded as one of the differential diagnosis for painful ophthalmoplegia refractory to corticosteroid therapy.
Lee
Dong Sub
DS
Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Woo
Kyung In
KI
Chang
Hae Ran
HR
D001706:Biopsy; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D016399:Lymphoma, T-Cell / Q000150:complications* / Q000175:diagnosis; D008875:Middle Aged; D009886:Ophthalmoplegia / Q000175:diagnosis / Q000209:etiology*; D009918:Orbital Neoplasms / Q000150:complications* / Q000175:diagnosis; D010146:Pain / Q000175:diagnosis / Q000209:etiology*; D014057:Tomography, X-Ray Computed