Extensive intracranial lesions in a case of orbital non-specific granuloma combined with polyarteritis nodosa

A unique case of a non-specific orbital granuloma in a 65-year-old woman is described. Necropsy disclosed extensive spread of the granuloma to the pachy- and leptomeninges as well as elsewhere. There were also signs of generalized polyarteritis nodosa. For five years the patient had severe facial pain and for four years signs of impaired renal function. A psychosis developed two months before her death. Previously she had had infections in the upper respiratory pathways and bilateral episcleritis. The nosology, aetiology, and pathogenesis of the condition are discussed.