EURORAD ESR

Case 15165

Multiple myeloma of the orbit

Author(s)
Dr. Akshay Pendkar1*, Dr. Nandish Kumar2 , Dr. Gaurav Parmar3 , Dr. Tosha Desai4 M.D., Dr. Nandini U. Bahri3 M.D.

1. Third year resident, Department of Radio diagnosis, M.P. Shah Government Medical College, Guru Gobind Singh Government Hospital, Jamnagar, Gujarat, India.
2. Third year resident, Department of Radio diagnosis, M.P. Shah Government Medical College, Guru Gobind Singh Government Hospital, Jamnagar, Gujarat, India.
3. Second year resident, Department of Radio diagnosis, M.P. Shah Government Medical College, Guru Gobind Singh Government Hospital, Jamnagar, Gujarat, India.
4. Tutor, Department of Radio diagnosis, M.P. Shah Government Medical College, Guru Gobind Singh Government Hospital, Jamnagar, Gujarat, India.
5. Professor, Department of Radio diagnosis, M.P. Shah Government Medical College, Guru Gobind Singh Government Hospital, Jamnagar, Gujarat, India.

SHRI GURU GOBIND SINGH HOSPITAL, SHRI GURU GOBIND SINGH HOSPITAL; P.N.MARG 361008 Jamnagar, India; Email:drakshay28@gmail.com
 
Patient
male, 36 year(s)
 
 
  • Figure 1
    Plain and Contrast CT orbit - Axial images
     

    Figure A showing plain axial section CT orbit demonstrating soft tissue lesions in left orbit (yellow arrows)

     
    Area of Interest: Eyes; Imaging Technique: CT; Procedure: Education; Special Focus: Haematologic diseases;

    Figure B showing contrast enhanced axial section CT orbit demonstrating mild enhancement in soft tissue lesions in left orbit (red arrows).

     
    Area of Interest: Eyes; Imaging Technique: CT; Procedure: Education; Special Focus: Haematologic diseases;
     
     
  • Figure 2
    Contrast enhanced CT orbit - Axial and Coronal images
     

    Figure A showing contrast enhanced axial section CT orbit demonstrating mild enhancing soft tissue lesion in right orbit (red arrow).

     
    Area of Interest: Eyes; Imaging Technique: CT; Procedure: Education; Special Focus: Haematologic diseases;

    Figure B showing coronal section contrast enhanced CT orbit demonstrating mild enhancing soft tissue lesions in bilateral orbits (yellow arrows).

     
    Area of Interest: Eyes; Imaging Technique: CT; Procedure: Education; Special Focus: Haematologic diseases;
     
     
  • Figure 3
    Bone window

    Bone window axial section CT Brain demonstrating multiple punched out lytic lesions involving skull bones (red arrows).

     
    Area of Interest: Musculoskeletal bone; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Metastases;
     
     
  • Figure 4
    MRI Brain T2WI and T1WI
     

    Figure A showing plain axial section T2 weighted MRI orbit image demonstrating hypointense soft tissue lesions in bilateral orbits (yellow arrows)

     
    Area of Interest: Eyes; Imaging Technique: MR; Procedure: Education; Special Focus: Haematologic diseases;

    Figure B showing plain axial section T1 weighted MRI orbit image demonstrating hypointense soft tissue lesion in bilateral orbits (yellow arrows)

     
    Area of Interest: Eyes; Imaging Technique: MR; Procedure: Education; Special Focus: Haematologic diseases;
     
     
  • Figure 5
    T2WI- Sagittal images
     

    Figure A showing plain sagittal section T2 weighted MRI orbit image demonstrating hypointense soft tissue lesion in left orbit (white arrow) in extraconal compartment that seems to be extending into left frontal bone...

     
    Area of Interest: Eyes; Imaging Technique: MR; Procedure: Education; Special Focus: Haematologic diseases;

    Figure B showing plain sagittal section T2 weighted MRI orbit image demonstrating hypointense soft tissue lesion in right orbit (white arrow) in extraconal compartment.

     
    Area of Interest: Eyes; Imaging Technique: MR; Procedure: Education; Special Focus: Haematologic diseases;
     
     
  • Figure 6
    Diffusion weighted image and ADC
     

    Figure A demonstrates no significant diffusion restriction in above mentioned orbital soft tissue lesions (Yellow arrows)

     
    Area of Interest: Eyes; Imaging Technique: MR; Procedure: Education; Special Focus: Haematologic diseases;

    Figure B demonstrates that above mentioned orbital soft tissue lesions appear dark on ADC (Red arrows)

     
    Area of Interest: Eyes; Imaging Technique: MR; Procedure: Education; Special Focus: Haematologic diseases;
     
     
  • Figure 7
    Histopathological confirmation

    Haematoxylin – Eosin stain revealed monomorphic lymphoid cells. It showed plamacytoid features with eccentric nuclei consistent with myeloma cells.

     
    Area of Interest: Eyes; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Haematologic diseases;
     
     
Figure A showing plain axial section CT orbit demonstrating soft tissue lesions in left orbit (yellow arrows)
 
Figure B showing contrast enhanced axial section CT orbit demonstrating mild enhancement in soft tissue lesions in left orbit (red arrows).
 
Figure A showing contrast enhanced axial section CT orbit demonstrating mild enhancing soft tissue lesion in right orbit (red arrow).
 
Figure B showing coronal section contrast enhanced CT orbit demonstrating mild enhancing soft tissue lesions in bilateral orbits (yellow arrows).
 
Bone window axial section CT Brain demonstrating multiple punched out lytic lesions involving skull bones (red arrows).
 
Figure A showing plain axial section T2 weighted MRI orbit image demonstrating hypointense soft tissue lesions in bilateral orbits (yellow arrows)
 
Figure B showing plain axial section T1 weighted MRI orbit image demonstrating hypointense soft tissue lesion in bilateral orbits (yellow arrows)
 
Figure A showing plain sagittal section T2 weighted MRI orbit image demonstrating hypointense soft tissue lesion in left orbit (white arrow) in extraconal compartment that seems to be extending into left frontal bone superiorly.
 
Figure B showing plain sagittal section T2 weighted MRI orbit image demonstrating hypointense soft tissue lesion in right orbit (white arrow) in extraconal compartment.
 
Figure A demonstrates no significant diffusion restriction in above mentioned orbital soft tissue lesions (Yellow arrows)
 
Figure B demonstrates that above mentioned orbital soft tissue lesions appear dark on ADC (Red arrows)
 
Haematoxylin – Eosin stain revealed monomorphic lymphoid cells. It showed plamacytoid features with eccentric nuclei consistent with myeloma cells.
 
 
 
Home Search Sections Teaching Cases History FAQ Case Archives Contact Login Disclaimer Imprint Switch to MOBILE version
View desktop version