PMC9743201_01
Preoperative image of the external eye in our patient at admission to our hospital.
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Palpation showed the distinct presence of nodules on both eyelids (Figure 1).
Contrast enhanced T2-weighted orbital MRI, showing thickened soft tissue around the orbit and enlargement of both lacrimal glands. (a) Coronal slice. (b) Horizontal slice.
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Although the anterior segment and fundus were normal, enhanced magnetic resonance imaging (MRI) of the eye showed thickened soft tissue around the orbit with heterogeneous enhancement (Figure 2).
Image of the excised orbital mass. The cut section of the specimen appears solid and tan-white.
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The excised mass was solid and tan-white in color (Figure 3).
Histopathological examination of the excised mass. (a) Histopathologic section stained with hematoxylin-eosin (H&E, magnification x200), showing foam cell granuloma with lymphocytes and plasma cell infiltration. (b) Positive staining for CD163 (magnification x400). (c) Positive staining for PGMS (magnification x400). (d) Positive staining for plasma cell CD138 (magnification x400). (e) Positive staining for MUM1 (magnification x400). (f) Sparse positive staining for IgG4 (magnification x400). (g) Sparse positive staining for CD20 in lymph cells (magnification x400). (h) Sparse positive staining for CD3 (magnification x400).
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The biopsy stained positive for CD163, propylene glycol mannate sulfate (PGMS), plasma cell CD138, multiple myeloma oncogene 1 (MUM1), IgG4 (sparse positive, 16/high-power field), lymph cell CD20 (partially positive), and CD3 (partially positive) (Figure 4).
Postoperative image of the external eye in our patient with AOSD at 20 months after surgery.
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After undergoing surgery, methylprednisolone and cyclosporine were given for 20 months, during which she showed good postoperative recovery, with resolution of eyelid nodules (Figure 5).