PMC4167026_01
(A and B) Magnetic Resonance Images Showing Abnormal Soft Tissue in the Inferomedial and Superior Aspects of the Left Orbit (arrows)
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F1
T1 signal in the central base of the skull and left pterygopalatine fossa as well as a focus of abnormal soft tissue in the inferomedial aspect of the left orbit measuring 1.4 cm in greatest diameter (Figure 1A and B). These findings were suggestive of neoplastic infiltration of the central skull base and multifocal disease in the orbit.
(A and B) Left Pterygomaxillary Biopsy Specimens Showing Infiltration by Small Lymphocytes Forming Small Aggregates (Hematoxylin and eosin x40 and x200 original magnification.)
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F2
The biopsy specimens revealed infiltration of small aggregates of monoclonal lymphocytes with surface expression of CD5, CD19, CD20(dim), CD22, CD23, CD38, CD200, and sIglambda(dim) but not CD10 or FMC7 (Figure 2A and B), which was compatible with a diagnosis of CLL/small lymphocytic leukemia (SLL) with no evidence of transformation.