Rare multiple orbital localizations of sarcoidosis. A case report

Pseudotumor of the orbit. Clinical, pathologic, and radiologic evaluation

Pseudotumor, Graves' disease, and lymphoproliferative disease are the most common ophthalmologic disease entities requiring evaluation by CT and MR imaging. A history of acute onset, pain, swelling, proptosis, and response to steroids are the classical findings. The radiologic findings are categorized according to location into dacryoadenitis, myositis, and sclerouveitis, with and without associated infiltrations. The inflammatory infiltrate, which is composed of polymorphic leukocytes, lymphocytes, and plasma cells interspersed with a variable amount of fibrovascular tissue, may be diffuse or localized. The preferred radiologic method used for assessment of pseudotumor is CT. MR imaging, however, is indicated for evaluation of the Tolosa-Hunt syndrome, which is characterized by an inflammatory infiltrate in the orbital apex and cavernous sinus leading to cranial nerve involvement with ophthalmoplegia. The clinical and radiologic constellation of findings allows a definitive diagnosis in most cases.

Lacrimal gland tumors and simulating lesions. Clinicopathologic and MR imaging features

The lacrimal gland region can be involved in a wide spectrum of orbital pathology, including inflammatory, lymphoproliferative, and epithelial tumors. This article focuses on benign and malignant epithelial tumors of lacrimal gland and simulating lesions. The clinical presentations, MR imaging, and pathologic findings of lacrimal gland tumors are reviewed.

Orbital and childhood sarcoidosis

Orbital infiltration, anterior uveitis, disc edema, choroiditis, erythema nodosum, and polyarticular arthritis due to sarcoidosis occurred in a five-year-old child who presented with unilateral proptosis. Diagnosis was enhanced by computerized tomography of the orbit, and confirmed by synovial biopsy findings. This patient's course illustrates the importance of thorough and frequent ocular examinations in childhood uveitis associated with systemic disease and demonstrates an unusual finding of orbital sarcoidosis. Childhood sarcoid arthritis may be misdiagnosed as juvenile rheumatoid arthritis. Familiarity with the ocular and systemic findings may lead to the correct diagnosis.

Neurosarcoidosis involving optic nerves and leptomeninges: computed tomography findings

A case of neurosarcoidosis with extensive involvement of both optic nerves and intracranial leptomeninges is reported. Computed tomography demonstrates diffuse enlargement of the optic nerves and extensive nodular contrast medium enhancement of the leptomeninges of the anterior and middle cranial fossae extending into the frontal convexity. Only one such case has been previously reported in the computed tomography literature. Marked therapeutic response was obtained clinically and demonstrated on a follow-up computed tomography after therapy with corticosteroids. Differential diagnosis of computed tomography findings is discussed.