[Orbital sarcoidosis—a case with an unusual course]

C Auw-Hädrich, J Gerling, H Witschel
Klinische Monatsblätter Für Augenheilkunde 1998, 212 (3): 181-3

BACKGROUND: Most cases of orbital sarcoidosis are associated with a systemic sarcoidosis.

PATIENTS AND METHODS: A 67-year-old woman suffered from an orbital mass on the right side, which led to disturbance of the ocular motility. Slight improvement was achieved by the administration of systemic steroids.

RESULTS: Histologically a chronic granulomatous inflammation was revealed in the biopsy of the orbital mass. The suspected diagnosis was sarcoidosis, but three conventional chest X-rays within 10 months and the serum angiotensin-converting-enzyme were normal. Suprisingly a computertomography of the chest showed mediastinal lymphomas.

CONCLUSION: Granulomatous orbital inflammation without any local cause or other systemic granulomatous disease strongly suggests a systemic sarcoidosis. In case of missing lymph node enlargement in conventional chest X-ray computertomography should be performed.

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