PMC5824895_01
Orbital imaging in the 3 cases. Arrows indicate the site of the inflammatory masses. (A, B) Axial and coronal CT reformats of case 1. (C, D) Axial and coronal MRI of case 1. (E, F) Axial and coronal CT reformats of case 2. (G, H) Axial and coronal CT reformats of case 3. CT indicates computed tomography; MRI, magnetic resonance imaging.
10.1177_1179552218757512-fig1.jpg
PMC5824895_03_10.1177_1179552218757512-fig1.jpg
fig1-1179552218757512
Computed tomography of the orbits showed an enlarged left lacrimal gland, which enhanced uniformly post-contrast (Figure 1G and H).
Representative histology using haematoxylin and eosin stain. (A) Orbital granuloma and (B) lacrimal granuloma with prominent vasculitis. Small arrow indicates granuloma, large outline arrow indicates vasculitis.
10.1177_1179552218757512-fig3.jpg
PMC5824895_02_10.1177_1179552218757512-fig3.jpg
fig3-1179552218757512
Histology showed a chronic dacryoadenitis, acute vasculitis of medium-sized vessels, and necrotizing histiocytic granulomas (Figure 3B).
PMC5824895_02
Orbital imaging in the 3 cases. Arrows indicate the site of the inflammatory masses. (A, B) Axial and coronal CT reformats of case 1. (C, D) Axial and coronal MRI of case 1. (E, F) Axial and coronal CT reformats of case 2. (G, H) Axial and coronal CT reformats of case 3. CT indicates computed tomography; MRI, magnetic resonance imaging.
10.1177_1179552218757512-fig1.jpg
PMC5824895_03_10.1177_1179552218757512-fig1.jpg
fig1-1179552218757512
Computed tomography of the orbits showed an enlarged left lacrimal gland, which enhanced uniformly post-contrast (Figure 1G and H).
Photographs of the patient in case 2 demonstrating the presenting signs and postoperative recovery. (A) At diagnosis, (B) immediately postoperatively, and (C) patient at 1-week post-discharge.
10.1177_1179552218757512-fig2.jpg
PMC5824895_02_10.1177_1179552218757512-fig2.jpg
fig2-1179552218757512
While off adalimumab for 1 week (recurrent viral infections), she presented with a 2-day history of acute onset of bilateral painful S-shaped periorbital swelling, moderate erythema, and chemosis worse on the left with diplopia (Figure 2A). Postoperative appearances are shown in Figure 2B. Following recommencement of weekly 25 mg subcutaneous methotrexate and biweekly adalimumab, her symptoms and signs had completely resolved at ophthalmological assessment 1 week later (Figure 2C).
Representative histology using haematoxylin and eosin stain. (A) Orbital granuloma and (B) lacrimal granuloma with prominent vasculitis. Small arrow indicates granuloma, large outline arrow indicates vasculitis.
10.1177_1179552218757512-fig3.jpg
PMC5824895_02_10.1177_1179552218757512-fig3.jpg
fig3-1179552218757512
Histology showed a chronic dacryoadenitis, acute vasculitis of medium-sized vessels, and necrotizing histiocytic granulomas (Figure 3B).
PMC5824895_03
Orbital imaging in the 3 cases. Arrows indicate the site of the inflammatory masses. (A, B) Axial and coronal CT reformats of case 1. (C, D) Axial and coronal MRI of case 1. (E, F) Axial and coronal CT reformats of case 2. (G, H) Axial and coronal CT reformats of case 3. CT indicates computed tomography; MRI, magnetic resonance imaging.
10.1177_1179552218757512-fig1.jpg
PMC5824895_03_10.1177_1179552218757512-fig1.jpg
fig1-1179552218757512
Computed tomography of the orbits showed an enlarged left lacrimal gland, which enhanced uniformly post-contrast (Figure 1G and H).