Ms.Mitali

Dr. khushboo Chawla

Abstract

24yr male with C/O of inferior orbital mass since 2mo,associated with weight loss & joint pains.

O/E BCVA of BE was 6/6.A well-defined mass in the left inferior orbit of size 2X1.5cm ,firm,non-tender with no overlying skin changes.Finger could not be insinuated beyond the posterior margin.No change in size of

the mass on valsalva.No bruit/thrill could be elicited.Normal ocular movements & no

proptosis.Pupils-NSRL.Investigations showed increased ESR(25mm/hr),

leukocytosis(13500/µl).USG:Well defined mass with constant echogenicity.No variability on color doppler.CT scan was s/o nonspecific orbital mass,no bony erosions or EOM involvment.Cervical LN biopsy was s/o reactive lymphadenitis.Excision biopsy

revealed a cellular lesion composed of numerous plasma cells.Immunohistochemistry for IgG4 was strongly positive(>40 plasma

cells/hpf).Dx of IgG4 related disease was confirmed.Patient was started on oral steroids 1mg/kg/day and complete surgical removal was done with no recurrence seen.