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Waldenstrom macroglobulinemia involving the superior rectus muscle
PURPOSE: We present the first reported case of Waldenstrom macroglobulinemia in the right superior rectus causing diplopia. OBSERVATIONS: A 72-year-old man with a 6-month history of untreated asymptomatic Waldenstrom macroglobulinemia presented with 2 years of diagonal binocular diplopia that was pr...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5956744/ https://www.ncbi.nlm.nih.gov/pubmed/29780960 http://dx.doi.org/10.1016/j.ajoc.2018.04.008 |
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author | Hellman, J.B. Harocopos, G.J. Lin, L.K. |
author_facet | Hellman, J.B. Harocopos, G.J. Lin, L.K. |
author_sort | Hellman, J.B. |
collection | PubMed |
description | PURPOSE: We present the first reported case of Waldenstrom macroglobulinemia in the right superior rectus causing diplopia. OBSERVATIONS: A 72-year-old man with a 6-month history of untreated asymptomatic Waldenstrom macroglobulinemia presented with 2 years of diagonal binocular diplopia that was previously thought to be due to ocular myasthenia gravis. Examination showed mild right proptosis and right hypotropia, and MRI revealed a focal lesion of the right superior rectus muscle. Orbital biopsy was performed, and histopathology showed lymphoplasmacytic infiltration among the skeletal muscle fibers of the rectus muscle. Immunostaining confirmed a B-cell preponderance, along with more extensive staining for IgM than IgG, and in situ hybridization confirmed lambda restriction. These findings corresponded with those of his previous bone marrow biopsy, confirming Waldenstrom macroglobulinemia as the etiology for the extraocular muscle mass. CONCLUSIONS AND IMPORTANCE: Lymphoma of an extraocular muscle is a rare manifestation of orbital lymphoma, and the tumors are usually mucosa-associated lymphoid tissue (MALT) lymphomas (i.e. extranodal marginal zone lymphomas). There are 4 previous reports of lymphoplasmacytic lymphoma of an extraocular muscle; however this is the first reported case of such a lesion in a patient with concurrent Waldenstrom macroglobulinemia at the time of diagnosis. |
format | Online Article Text |
id | pubmed-5956744 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-59567442018-05-18 Waldenstrom macroglobulinemia involving the superior rectus muscle Hellman, J.B. Harocopos, G.J. Lin, L.K. Am J Ophthalmol Case Rep Brief report PURPOSE: We present the first reported case of Waldenstrom macroglobulinemia in the right superior rectus causing diplopia. OBSERVATIONS: A 72-year-old man with a 6-month history of untreated asymptomatic Waldenstrom macroglobulinemia presented with 2 years of diagonal binocular diplopia that was previously thought to be due to ocular myasthenia gravis. Examination showed mild right proptosis and right hypotropia, and MRI revealed a focal lesion of the right superior rectus muscle. Orbital biopsy was performed, and histopathology showed lymphoplasmacytic infiltration among the skeletal muscle fibers of the rectus muscle. Immunostaining confirmed a B-cell preponderance, along with more extensive staining for IgM than IgG, and in situ hybridization confirmed lambda restriction. These findings corresponded with those of his previous bone marrow biopsy, confirming Waldenstrom macroglobulinemia as the etiology for the extraocular muscle mass. CONCLUSIONS AND IMPORTANCE: Lymphoma of an extraocular muscle is a rare manifestation of orbital lymphoma, and the tumors are usually mucosa-associated lymphoid tissue (MALT) lymphomas (i.e. extranodal marginal zone lymphomas). There are 4 previous reports of lymphoplasmacytic lymphoma of an extraocular muscle; however this is the first reported case of such a lesion in a patient with concurrent Waldenstrom macroglobulinemia at the time of diagnosis. Elsevier 2018-04-18 /pmc/articles/PMC5956744/ /pubmed/29780960 http://dx.doi.org/10.1016/j.ajoc.2018.04.008 Text en © 2018 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Brief report Hellman, J.B. Harocopos, G.J. Lin, L.K. Waldenstrom macroglobulinemia involving the superior rectus muscle |
title | Waldenstrom macroglobulinemia involving the superior rectus muscle |
title_full | Waldenstrom macroglobulinemia involving the superior rectus muscle |
title_fullStr | Waldenstrom macroglobulinemia involving the superior rectus muscle |
title_full_unstemmed | Waldenstrom macroglobulinemia involving the superior rectus muscle |
title_short | Waldenstrom macroglobulinemia involving the superior rectus muscle |
title_sort | waldenstrom macroglobulinemia involving the superior rectus muscle |
topic | Brief report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5956744/ https://www.ncbi.nlm.nih.gov/pubmed/29780960 http://dx.doi.org/10.1016/j.ajoc.2018.04.008 |
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