PMC8445722_01
Orbital cellulitis at presentation in the left eye (front and lateral view).
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Koirala Institute of Health Sciences, with sudden onset of painful proptosis associated with visual impairment in the left eye for 15 days (Figure 1).
Conjunctival congestion with tortuous vessels in the left eye.
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There was diffuse conjunctival congestion with chemosis and dilated tortuous vessels over the upper bulbar conjunctiva (Figure 2).
Blurred disc margin with chorioretinal folds in the left eye.
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A dilated funduscopic examination of the left eye revealed optic disc edema of one diopter elevation with chorioretinal folds in the inferior quadrants (Figure 3).
USG B-scan: homogenous mass distorting the globe inferiorly (as shown by an arrow) in the left eye.
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USG B-scan of the left eye showed normal intraocular structures with the presence of homogeneous mass behind the globe inferiorly (Figure 4).
CECT-orbit: contrast enhanced intraorbital mass involving the optic nerve (as shown by an arrow in (a)) and the mass extending to sinonasal cavity (as shown by an arrow in (b)).
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It also involved the soft tissue of the anterior orbit with homogenous opacity in the ethmoidal and maxillary sinuses with few probable sites of bony erosions (Figures 5(a) and 5(b)).
Endoscopic biopsy specimen (H&E x20). Microphotograph shows the H&E-stained section showing diffuse proliferation of atypical cells with apoptotic bodies.
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Proliferating capillaries and few inflammatory cells were seen in between suggestive of non-Hodgkin Lymphoma (Figure 6).