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Case Reports in Ophthalmological Medicine
Volume 2017, Article ID 8902162, 5 pages
https://doi.org/10.1155/2017/8902162
Case Report

Orbital T-Cell Lymphoma with Discrete Enlargements of All Extraocular Muscles Bilaterally in Patient with Moon Face Countenance

1Department of Ophthalmology, Gifu Municipal Hospital, Gifu, Japan
2Department of Ophthalmology, Gifu University Graduate School of Medicine, Gifu, Japan
3Department of Hematology, Gifu Municipal Hospital, Gifu, Japan
4Department of Pathology, Gifu Municipal Hospital, Gifu, Japan

Correspondence should be addressed to Hideaki Kawakami; pj.ca.nimu@fig-awakh

Received 21 January 2017; Accepted 2 April 2017; Published 9 April 2017

Academic Editor: Alexander A. Bialasiewicz

Copyright © 2017 Hideaki Kawakami et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose. To report our findings in a case of orbital T-cell lymphoma in which all of the extraocular muscles (EOMs) were bilaterally and discretely enlarged and the patient had a moon face countenance. Case. A 59-year-old woman presented with visual disturbances in her left eye, hyperemia in both eyes, and a moon face countenance. Examinations showed limited upward gaze in the right eye, blepharoptosis, hypertropia, and limited downward and rightward gaze in the left eye. Slit-lamp examination showed only chemosis and hyperemia of both eyes. Magnetic resonance imaging with contrast revealed discrete enlargements of the muscle bellies in all EOMs without abnormalities of the orbital fat in both eyes. Blood examinations excluded thyroid- and IgG4-related ophthalmopathy, and EOM biopsy revealed peripheral T-cell lymphoma. After beginning aggressive chemotherapy, the enlarged EOMs, limited eye motility, and moon face countenance improved. Unfortunately, the patient died of sepsis during the chemotherapy. Conclusions. A lymphoma should be included in the differential diagnosis of eyes with enlarged EOMs. Because lymphomas can lead to death, it is important for clinicians to consider lymphomas in eyes with enlarged EOMs.