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Eyelid involvement in multicentric reticulohistiocytosis
R C Eagle1, R A Penne, I S Hneleski
1Department of Pathology, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA 19107.
Case Report:
The authors report the first biopsy-confirmed ocular adnexal involvement by multicentric reticulohistiocytosis. The patient was a 28-year-old black woman with a 15-year history of well-documented multicentric reticulohistiocytosis who had multiple dermal nodules and severe mutilating arthritis that had produced a characteristic telescoping deformity of the digits. Eyelid nodules were excised to relieve pseudoptosis and for cosmesis.
Materials:
The eyelid nodules were studied by routine light microscopy and a battery of immunohistochemical stains, including S-100 protein and several macrophage markers.
Results:
Microscopy disclosed an infiltrate of histiocytes and giant cells with glassy eosinophilic cytoplasm and large round or oval vesicular nuclei with prominent nucleoli set in a densely fibrotic stroma consistent with multicentric reticulohistiocytosis. The histiocytes showed positive immunoreactivity for lysozyme, but were negative for alpha-1 antichymotrypsin, S-100 protein, and neuron-specific enolase.
Conclusion:
Multicentric reticulohistiocytosis should be included in the differential diagnosis of multiple eyelid nodules.