PMC5943986_01
Magnetic resonance images of the left superior oblique (SO) muscle isolated enlargement (Black arrow) in 3 different consecutive images: T2-weighted coronal image with fat suppression, Post-contrast T1-weighted axial image with fat suppression, and diffusion-weighted axial image.
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T2-weighted images and intense enhancement following intravenous injection of contrast media with diffusion-weighted Image on b = 1000 and b = 0 sequences. The apparent diffusion coefficient (ADC) was (0.77 +- 0.11 x 10-3 mm2/s) determined by the manual region-of-interest intensity with diffusion pattern relatively low signal intensity within the lesion compared to that of brain parenchyma. There was no evidence of infiltration of the adjacent superior rectus and medial rectus muscles with normal surrounding fat (Fig. 1).
Microphotograph of the SO muscle biopsy showing the muscle fibers separated by diffuse proliferation of small round cells with dark nuclei and minimal cytoplasm representing mature lymphocytes (Original magnification x200. Hematoxylin and eosin).
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Occasional larger lymphoid cells and some plasma cells were also present (Fig. 2).
The immunohistochemical profile of the lymphocytic proliferation showing expression of cells to CD20 in A, CD43 in B, and Bcl-2 in C. Note the absence of expression of the following markers: CD10, CD30, and Bcl-6 in D, E, and F confirming the diagnosis of extra-nodal marginal-zone lymphoma (Original magnification x100).
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Immunohistochemical staining showed a predominant infiltrate of B-lymphocytes that was CD20, CD43 and Bcl-2 positive and CD10, CD30 and Bcl-6 negative (Fig. 3).