Orbital lymphoma associated with Graves’ disease: A case report
Introduction. The presence of bilateral exophthalmos and palpebral, periorbital edema associated with hyperthyroidism is most often considered as an initial sign of Graves’ ophthalmopathy. However, in up to 20% of cases, Graves’ ophthalmopathy might precede the occurrence of hyperthyroidism...
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| Format: | Article |
| Language: | English |
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Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade
2014-01-01
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| Series: | Vojnosanitetski Pregled |
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| Online Access: | http://www.doiserbia.nb.rs/img/doi/0042-8450/2014/0042-84501405510H.pdf |
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| author | Hajduković Zoran Kuzmić-Janković Snežana Kljaković-Avramović Tamara Sekulović Leposava Tukić Ljiljana |
| author_facet | Hajduković Zoran Kuzmić-Janković Snežana Kljaković-Avramović Tamara Sekulović Leposava Tukić Ljiljana |
| author_sort | Hajduković Zoran |
| collection | DOAJ |
| description | Introduction. The presence of bilateral exophthalmos and palpebral,
periorbital edema associated with hyperthyroidism is most often considered as
an initial sign of Graves’ ophthalmopathy. However, in up to 20% of cases,
Graves’ ophthalmopathy might precede the occurrence of hyperthyroidism, which
is very important to be considered in the differential diagnosis, especially
if it is stated as unilateral. Among other less common causes of
non-thyroid-related orbitopathy, orbital lymphoma represents rare conditions.
We presented of a patient with Graves’ disease, initially manifested as
bilateral orbitopathy and progressive unilateral exophthalmos caused by the
marginal zone B-cell non-Hodgkin lymphoma of the orbit. Case report. A
64-yearold man with the 3-year history of bilateral Graves’ orbitopathy and
hyperthyroidism underwent the left orbital decompression surgery due to the
predominantly left, unilateral worsening of exophthalmos resistant to the
previously applied glucocorticoid therapy. A year after the surgical
treatment, a substantial exophthalmos of the left eye was again observed,
signifying that other non-thyroid pathology could be involved. Orbital
ultrasound was suggestive of primary orbital lymphoma, what was confirmed by
orbital CT scan and the biopsy of the tumor tissue. Detailed examinations
indicated that the marginal zone B-cell non-Hodgkin lymphoma extended to IV
- B-b CS, IPI 3 (bone marrow infiltration: m+ orbit+). Upon the completion of
the polychemiotherapy and the radiation treatment, a complete remission of
the disease was achieved. Conclusion. Even when elements clearly indicate the
presence of thyroid-related ophthalmopathy, disease deteriorating should
raise a suspicion and always lead to imaging procedures to exclude
malignancy. |
| format | Article |
| id | doaj-art-a29337ef0c9041a5aab2e94abab5f0ff |
| institution | OA Journals |
| issn | 0042-8450 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade |
| record_format | Article |
| series | Vojnosanitetski Pregled |
| spelling | doaj-art-a29337ef0c9041a5aab2e94abab5f0ff2025-08-20T02:00:43ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502014-01-0171551051410.2298/VSP1405510H0042-84501405510HOrbital lymphoma associated with Graves’ disease: A case reportHajduković Zoran0Kuzmić-Janković Snežana1Kljaković-Avramović Tamara2Sekulović Leposava3Tukić Ljiljana4Military Medical Academy, Clinic for Endocrinology, Belgrade + University of Defence, Faculty of Medicine of the Military Medical Academy, BelgradeMilitary Medical Academy, Clinic for Endocrinology, BelgradeMilitary Medical Academy, Clinic for Ophthalmology, BelgradeUniversity of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade + Military Medical Academy, Institute of Radiology, BelgradeUniversity of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade + Military Medical Academy, Clinic for Haematology, BelgradeIntroduction. The presence of bilateral exophthalmos and palpebral, periorbital edema associated with hyperthyroidism is most often considered as an initial sign of Graves’ ophthalmopathy. However, in up to 20% of cases, Graves’ ophthalmopathy might precede the occurrence of hyperthyroidism, which is very important to be considered in the differential diagnosis, especially if it is stated as unilateral. Among other less common causes of non-thyroid-related orbitopathy, orbital lymphoma represents rare conditions. We presented of a patient with Graves’ disease, initially manifested as bilateral orbitopathy and progressive unilateral exophthalmos caused by the marginal zone B-cell non-Hodgkin lymphoma of the orbit. Case report. A 64-yearold man with the 3-year history of bilateral Graves’ orbitopathy and hyperthyroidism underwent the left orbital decompression surgery due to the predominantly left, unilateral worsening of exophthalmos resistant to the previously applied glucocorticoid therapy. A year after the surgical treatment, a substantial exophthalmos of the left eye was again observed, signifying that other non-thyroid pathology could be involved. Orbital ultrasound was suggestive of primary orbital lymphoma, what was confirmed by orbital CT scan and the biopsy of the tumor tissue. Detailed examinations indicated that the marginal zone B-cell non-Hodgkin lymphoma extended to IV - B-b CS, IPI 3 (bone marrow infiltration: m+ orbit+). Upon the completion of the polychemiotherapy and the radiation treatment, a complete remission of the disease was achieved. Conclusion. Even when elements clearly indicate the presence of thyroid-related ophthalmopathy, disease deteriorating should raise a suspicion and always lead to imaging procedures to exclude malignancy.http://www.doiserbia.nb.rs/img/doi/0042-8450/2014/0042-84501405510H.pdfexophthalmosdiagnosis, differentialgraves diseasehistological techniques |
| spellingShingle | Hajduković Zoran Kuzmić-Janković Snežana Kljaković-Avramović Tamara Sekulović Leposava Tukić Ljiljana Orbital lymphoma associated with Graves’ disease: A case report Vojnosanitetski Pregled exophthalmos diagnosis, differential graves disease histological techniques |
| title | Orbital lymphoma associated with Graves’ disease: A case report |
| title_full | Orbital lymphoma associated with Graves’ disease: A case report |
| title_fullStr | Orbital lymphoma associated with Graves’ disease: A case report |
| title_full_unstemmed | Orbital lymphoma associated with Graves’ disease: A case report |
| title_short | Orbital lymphoma associated with Graves’ disease: A case report |
| title_sort | orbital lymphoma associated with graves disease a case report |
| topic | exophthalmos diagnosis, differential graves disease histological techniques |
| url | http://www.doiserbia.nb.rs/img/doi/0042-8450/2014/0042-84501405510H.pdf |
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