Korean J Ophthalmol.  2013 Feb;27(1):52-54. 10.3341/kjo.2013.27.1.52.

Orbital Sarcoidosis Presenting as Diffuse Swelling of the Lower Eyelid

• Lee JK
• Moon NJ

• KMID: 1501797
• DOI: http://doi.org/10.3341/kjo.2013.27.1.52

Abstract

The author reports a case of orbital Sarcoidosis in a 70-year-old female that initially presented as diffuse swelling of the lower eyelid. The patient complained of painless swelling of the left lower lid without palpable mass, and a computerized tomography (CT) scan of the orbit was unremarkable. A serum angiotensin converting enzyme level was elevated, and hilar lymphadenopathy was noted on the chest CT. The patient underwent surgical debulking for histologic confirmation, which led to a final diagnosis of sarcoidosis involving the orbital fat. Unexplained chronic eyelid swelling without a mass should be considered a possible ophthalmic manifestation of orbital sarcoidosis.

Keyword

Chronic swelling; Lower lid; Orbital sarcoidosis

MeSH Terms

Aged
Biopsy
Diagnosis, Differential
Edema/diagnosis/*etiology
Eyelid Diseases/diagnosis/*etiology
Eyelids/*pathology
Female
Humans
Orbital Diseases/*complications/diagnosis
Sarcoidosis/*complications/diagnosis
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 (A) Photograph of a 70-year-old female with diffuse swelling of the left lower eyelid. Computed tomographic scans, (B) axial and (C) coronal, showed no evidence of a mass lesion or soft tissue infiltration.

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  Fig. 2 Chest radiograph shows multiple confluent irregular opacities (arrow) in right upper lobe. There are no remarkable findings in hilar region with shadow of aortic arch (arrowhead).

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  Fig. 3 (A) There are multifocal granulomas with lymphocytic infiltration in the fat (H&E, ×40). (B) High magnification view shows a well-formed, non-caseating granuloma composed of epithelioid histiocytes with surrounding lymphocytes (H&E, ×400).

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  Fig. 4 (A) The patient showed significant improvement of the left lower lid swelling after surgery. (B) Left lower lid swelling was completely resolved after low dose steroid treatment.

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