PMC4889789_01
Hard and cold edema of the lower left eyelid with discreet ipsilateral proptosis.
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fig1
Hertel exophthalmometry was used to measure the degree of ocular protrusion and the value obtained was 18,2 mm for the right eye and 25 mm for the left eye (Figure 1).
Coronal T1 fat-saturated postgadolinium: solid mass enhancing the gadolinium, located within retroconal, pre- and post-septal, and inferolateral regions.
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fig2
Magnetic resonance of the orbit showed left eye proptosis and thickening and increase of soft tissues associated with heterogeneous impregnation of contrast in the infralateral region of the left eyelid (Figures 2 and 3).
Axial T2-anterior projection of the left eye globe in relation to the contralateral.
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fig3
Magnetic resonance of the orbit showed left eye proptosis and thickening and increase of soft tissues associated with heterogeneous impregnation of contrast in the infralateral region of the left eyelid (Figures 2 and 3).
Extensive multifocal chronic granulomatous inflammation, with numerous epithelioid macrophages and multinucleated giant cells, without evidence of necrosis (HE 100x).
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fig4
Histology showed a chronic inflammatory process, well-formed, tightly packed, with nonnecrotizing granulomas surrounded by lamellar hyaline collagen, and negative immune-histochemistry for mycobacteria, providing histological confirmation of sarcoidosis (Figure 4).