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Orbital lymphoma masquerading as thyroid ophthalmopathy
1Illinois Eye Institute, Illinois College of Optometry, Chicago, USA.
Journal of the American Optometric Association
|November 7, 1998
Summary
Orbital lymphoma can mimic Graves' disease, causing eye swelling and proptosis. Early diagnosis is crucial, as this rare condition can be mistaken for more common thyroid-related eye issues.
Area of Science:
- Ophthalmology
- Oncology
- Endocrinology
Background:
- Lymphoid tumors can affect the lacrimal gland and orbital fat, presenting with proptosis and globe displacement.
- Graves' ophthalmopathy is a common orbital pathology with symptoms like proptosis and extraocular muscle limitations, which are not always specific.
Observation:
- A 57-year-old man presented with persistent eye swelling, initially treated as hyperthyroidism with multiple orbital decompressions.
- Clinical examination revealed significant proptosis, exophthalmometry readings, and restricted eye movements.
- Subsequent thyroid tests confirmed euthyroid status, and a CT scan identified orbital lymphoma.
Findings:
- The patient's orbital lymphoma presented with proptosis and gaze restrictions, closely resembling Graves' ophthalmopathy.
- Malignant nodular histiocytic lymphoma was diagnosed as the cause of the orbital mass and associated symptoms.
Implications:
- This case highlights the importance of considering space-occupying lesions in the differential diagnosis of proptosis and gaze restrictions.
- Accurate diagnosis of orbital lymphoma is critical, as it can be easily misdiagnosed as Graves' disease, potentially delaying appropriate treatment.