Titre du document / Document title

Beidseitige ausgeprägte konjunktivale Tumoren als Primärmanifestation einer Sarkoidose - : erfolgreiche Therapie mit Steroid-Depot-Injektionen = Bilateral large conjunctival tumours as primary manifestation of sarcoidosis- : successful treatment with steroid-depot-injections

Auteur(s) / Author(s)

SCHILGEN G. ; SUNDMACHER R. ; POMJANSKI N. ; BÖCKING A. ; REINECKE P. ; GABBERT H. E. ;

Résumé / Abstract

Introduction: Ocular manifestations of sarcoidosis vary enormously. They include the conjunctiva, lacrimal gland, orbita, intraocular structures and eye-lid, either isolated or combined. We describe a female patient who presented with unusually large, bilateral conjunctival tumours as a primary manifestation of sarcoidosis. Patient: A 79-year-old white woman was referred to us for further management of a persisting "conjunctivitis", which had been refractory to treatment with multiple medications. Initial examination disclosed swollen eye-lids and bilateral large hard tumours of the inferior fornix. The obtained brush smear, which was cytopathologically evaluated, revealed epitheloid cells and multinucleate giant cells. After 4 weeks she developed three reddish-brown maculopapular lesions on her face. The subsequent biopsy from the left inferior fornix and the skin showed histopathologically a granulomatous epitheloid cell inflammation without central necrosis and without acid-proof bacilli. Therefore a sarcoidosis was included into the differential diagnosis. The systemic evaluation revealed no other manifestation. At first we tried to reduce the chronically inflammatory tumours with different immunomodulating local treatment forms. Only the repeated intralesional injection of a steroid depot showed a complete disappearance of all conjunctival and skin tumours. Conclusion: An isolated bilateral primary manifestation of sarcoidosis with large massive conjunctival tumours is very rare and clinically not typical. The non-invasive, cytopathological examination by means of brush smears offers a new perspective in the fast diagnosis of conjunctival manifestation ofsarcoidosis. The tumours respond excellently to the intralesional injection of steroid depots.

Revue / Journal Title

Klinische Monatsblätter für Augenheilkunde   ISSN 0023-2165   CODEN KMAUAI 

Source / Source

2006, vol. 223, n^o4, pp. 326-329 [4 page(s) (article)]

Langue / Language

Allemand

Editeur / Publisher

Thieme, Stuttgart, ALLEMAGNE  (1963) (Revue)

Mots-clés d'auteur / Author Keywords

Sarcoidosis ; primary manifestation ; conjunctiva ; tumour ; conjunctivitis ; cytopathology ; histopathology ; intralesional injection ; steroids ;

Localisation / Location

INIST-CNRS, Cote INIST : 3850 A, 35400015322283.0110