PMC7758142_01
Reduction of swelling and erythema was noted around the right paranasal sinuses and right eye after nasal washout.
CRIM2020-6646693.001.jpg
PMC7758142_01_CRIM2020-6646693.001.jpg
fig1
Postoperatively, the patient felt better and the swelling and erythema around the right eye markedly decreased (see Figure 1).
Exuberant periorbital edema, erythema, and superficial excoriation with serous drainage were noted over the right eye and right paranasal region.
CRIM2020-6646693.002.jpg
PMC7758142_01_CRIM2020-6646693.002.jpg
fig2
However, the patient continued to have worsening right periorbital edema, erythema, and chemosis despite on appropriate antibiotic therapy (see Figure 2).
There were dense atypical lymphoid cells with irregular nucleoli (H&E stain, 400X).
CRIM2020-6646693.003.jpg
PMC7758142_01_CRIM2020-6646693.003.jpg
fig3
T cells with irregular nucleoli (see Figure 3), which were positive for natural killer cells or cytotoxic T-cell markers:CD2, CD3, and CD56 on the immunohistochemistry study. The neoplastic cells were negative for CD4, CD8, and CD7 on immunophenotype evaluation.
In situ hybridization was diffusely positive for Epstein-Barr virus (EBV) RNA.
CRIM2020-6646693.004.jpg
PMC7758142_01_CRIM2020-6646693.004.jpg
fig4
In situ hybridization was strongly positive for Epstein-Barr virus (EBV) RNA (see Figure 4).
Significant resolution of the right periorbital edema and erythema was noted after 3 cycles of chemotherapy. The right eye was eventually able to fully open.
CRIM2020-6646693.005.jpg
PMC7758142_01_CRIM2020-6646693.005.jpg
fig5
The right periorbital edema and erythema had almost resolved (see Figure 5).