MIDLINE GRANULOMA PRESENTING AS ORBITAL CELLULITIS

Background: Lethal midline granuloma usually presents with rhinorrhoea and redness of the skin above the nose. Early ocular symptoms are ver y rare. We here describe a patient who presented with acute orbital ce llulitis. Patient: A 73-year-old woman had a 24-h history of severe pa in around her left eye. We saw the typical clinical picture of orbital cellulitis. A CT scan revealed a diffuse infiltration of the left upp er and lower lid, the anterior orbit and the ethmoidal sinuses. Result : On surgical exploration we found a granular, partly necrotic tumour. Histological examination revealed an angiocentric nasal T-cell lympho ma (midline granuloma). Conclusion: Midline granuloma should be includ ed in the differential diagnosis of acute orbital cellulitis.