ORBITAL SARCOIDOSIS - A CASE WITH AN UNUS UAL COURSE

Background Most cases of orbital sarcoidosis are associated with a sys temic sarcoidosis. Patients and methods A 67-year-old woman suffered f rom an orbital mass on the right side, which led to disturbance of the ocular motility. Slight improvement was achieved by the administratio n of systemic steroids. Results Histologically a chronic granulomatous inflammation was revealed in the biopsy of the orbital mass. The susp ected diagnosis was sarcoidosis, but three conventional chest X-rays w ithin 10 months and the serum angiotensin-converting-enzyme were norma l. Suprisingly a computertomography of the chest showed mediastinal ly mphomas. Conclusion Granulomatous orbital inflammation without any loc al cause or other systemic granulomatous disease strongly suggests a s ystemic sarcoidosis. In case of missing lymph node enlargement in conv entional chest X-ray computertomography should be performed.