J Korean Ophthalmol Soc.  2018 Jul;59(7):672-675. 10.3341/jkos.2018.59.7.672.

A Case of Orbital Lymph Node Misdiagnosed as a Dermoid

• Ahn J
• Park MH
• Yoo JM
• Seo SW

• KMID: 2416270
• DOI: http://doi.org/10.3341/jkos.2018.59.7.672

Abstract

PURPOSE
We report our experience with a case of orbital lymph node which has not been previously reported in the Republic of Korea.
CASE SUMMARY
A 24-year-old female patient with no underlying disease visited our hospital with a 2-month history of a mass at the lateral side of the left upper eyelid. On physical examination, a round, well-defined subcutaneous mass was palpable, and pain, swelling or a skin change were not reported or seen. The appearance, location, and imaging findings of the mass were suspected to be dermoid, and excisional biopsy was performed for accurate diagnosis and treatment. The 1.0 × 0.7 cm-sized, round-shaped and brown-colored mass was excised. The mass was well-defined but in the posterior part; it was attached to the periosteum. The mass was finally diagnosed as a lymph node with lymphadenitis by histopathological examination. No recurrence or new lesion was observed after surgery, and the patient did not complain of abnormal symptoms.
CONCLUSIONS
A Complete orbital lymphoid tissue has not yet been found in the orbit, and lymph nodes are known to be absent. However, as in this case, when an orbital mass is observed, the possibility of lymph node should be considered and histopathological examination should be performed to confirm it.

Keyword

Lymph node; Orbital lymphoid tissue; Orbital mass

MeSH Terms

Biopsy
Dermoid Cyst*
Diagnosis
Eyelids
Female
Humans
Lymph Nodes*
Lymphadenitis
Lymphoid Tissue
Orbit*
Periosteum
Physical Examination
Recurrence
Republic of Korea
Skin
Young Adult

Figure

• 

  Figure 1. Clinical photograph. (A) 0.4 × 0.5 cm sized movable mass (black arrow) is seen on the lateral side of the upper eyelid. (B) Slightly elevated mass (black arrow) is seen at lateral view photograph.

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  Figure 2. Preoperative non enhanced computed tomography images. (A) Axial view image. The white arrow indicates a mass. (B) The white arrow indicates a mass at coronal view image.

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  Figure 3. Photography of the removed mass. (A) An approximately 1.0 × 0.7 cm sized mass was excised. (B) Microscopic image of the lymph node under a light microscope (hematoxylin and eosin stain, ×10). A node consists of two main regions germinal center in cortex (black arrow) and medullar (white arrow). (C) Follicle with germinal center (hematoxylin and eosin stain, ×100).

Reference

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