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目的:报告罕见突眼急性发作病例继发于皮下脂膜炎样T细胞淋巴瘤(SPTCL)1例。方法:病例报告。结果:患者,男,27岁,马来人,左眼眼球突出急性发病2wk。伴随长期高烧病史。在此期间他的身体和双大腿还多发肿胀红斑。双眼视力为6/6。左眼眼球突出和球结膜水肿。各个方向眼外运动受限。角膜和眼前段正常。眼底检查显示正常视盘和视网膜。右眼检查为正常。体温40.0℃,全身多发皮下红斑病灶主要分布在左腋下、右季肋部、双大腿和耻骨上区。腹股沟淋巴结也是可触及的。脑磁共振成像显示左冠外和眶后广泛软组织肿胀,暗示着炎症反应。海绵窦和大脑正常。红斑病灶处皮肤切片揭示为SPTCL。其被提交给血液病医师,并开始CHOP方案化疗。患者化疗反应良好,眼球突出复位。结论:眼球突出继发于SPTCL是非常罕见的。这是一个外周T细胞淋巴瘤的变异,特点是多发皮下结节表现为眼球突出和发烧。
AIM: To report a case of acute exacerbation of rare exophthalmos in 1 patient with subcutaneous panniculitis-like T-cell lymphoma (SPTCL). Methods: Case report. Results: Patient, male, 27 years old, Malay, left eye with acute onset of acute eye 2wk. With a long history of high fever. During this period his body and double thighs are more swollen erythema. Binocular vision is 6/6. Left eye and bulbar conjunctival edema prominent. Eye movement in all directions is limited. Cornea and anterior segment normal. Fundus examination showed normal optic disc and retina. Right eye examination is normal. Body temperature 40.0 ℃, systemic multiple subcutaneous erythema lesions are mainly distributed in the left armpit, right quarter rib, double thigh and suprapubic area. Inguinal lymph nodes are also palpable. Brain magnetic resonance imaging showed extensive swelling of the left and right retro-orbital soft tissues, suggesting an inflammatory response. Cavernous sinus and brain normal. Skin patches at erythema lesions are revealed as SPTCL. It was submitted to a hematologist and started CHOP regimen chemotherapy. Chemotherapy in patients with good, prominent eye reset. Conclusions: It is very rare that the eyeball is secondary to SPTCL. This is a variant of peripheral T-cell lymphoma that is characterized by multiple subcutaneous nodules that present with exophthalmos and fever.