PDF(Pubmed)
Abstract：
Pseudolymphoma (PSL) of the orbit is a benign lymphoid hyperplasia (LH). It is a rare disease with an extensive range of known causative agents. LH is further classified into \"reactive\" (RLH) and \"atypical\" (ALH) types. It clinically presents as a single or a few plaques and/or nodular lesions, particularly on the head, neck, and upper trunk. It must be differentiated from orbital malignant lymphoma. In this report, we present a case of a 58-year-old Pakistani female with an asymptomatic recurrent right periorbital swelling for three years. It was clinically diagnosed as an angiotensin-converting enzyme (ACE) inhibitor-induced angioedema as it responded to stopping the ACE inhibitor; however, after four months, the patient again started to develop right periorbital swelling. An incisional biopsy revealed perivascular and periadnexal infiltration of lymphocytes, plasma cells, and a few neutrophils along with pigmentary incontinence. The formation of multiple lymphoid follicles and infiltration by monomorphic lymphoid cells in deeper skeletal muscle fibers were also observed. Immunohistochemistry (IHC) showed polyclonality and low Ki-67 labeling (20%), corresponding to periorbital RLH. Our objective in this study is to highlight the importance of considering PSL as a differential diagnosis in periorbital swelling. We also suggest that recurrent angioedema may lead to PSL.
摘要：
眼眶假性淋巴瘤（PSL）是良性淋巴增生（LH）。这是一种罕见的疾病，具有广泛的已知病原体。LH进一步分为“反应性”（RLH）和“非典型”（ALH）类型。临床上表现为单个或几个斑块和/或结节性病变，尤其是头部,脖子,和上树干。必须与眼眶恶性淋巴瘤区分开来。在这份报告中,我们介绍一例58岁的巴基斯坦女性无症状复发性右眶周肿胀3年.临床诊断为血管紧张素转换酶（ACE）抑制剂引起的血管性水肿，因为它对停止ACE抑制剂有反应；然而，四个月后,患者再次开始出现右眶周肿胀。切开活检显示血管周围和附件周围淋巴细胞浸润，浆细胞,和一些中性粒细胞以及色素性尿失禁。还观察到多个淋巴滤泡的形成和单形淋巴样细胞在更深的骨骼肌纤维中的浸润。免疫组织化学（IHC）显示多克隆性和低Ki-67标记（20％），对应于眶周RLH。我们在这项研究中的目的是强调将PSL作为眶周肿胀的鉴别诊断的重要性。我们还建议复发性血管性水肿可能导致PSL。
