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ARTICLES
Year : 1974  |  Volume : 22  |  Issue : 3  |  Page : 22-23

Reticulum cell sarcoma producing bilateral proptosis


Departments of Pathology and Neuro-Surgery Kurnool Medical College, Kurnool (AP)., India

Correspondence Address:
G Chengal Raju
Departments of Pathology and Neuro-Surgery Kurnool Medical College, Kurnool (AP).
India
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Source of Support: None, Conflict of Interest: None


PMID: 4619110

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How to cite this article:
Raju G C, Reddy D B, Dinakar I, Suvarnakumari G. Reticulum cell sarcoma producing bilateral proptosis. Indian J Ophthalmol 1974;22:22-3

How to cite this URL:
Raju G C, Reddy D B, Dinakar I, Suvarnakumari G. Reticulum cell sarcoma producing bilateral proptosis. Indian J Ophthalmol [serial online] 1974 [cited 2020 Apr 4];22:22-3. Available from: http://www.ijo.in/text.asp?1974/22/3/22/31352

The reticulum cell sarcoma arises from the undifferentiated mesenchymal cell. This type of tumour most frequently is found in lymph­nodes, though it can occur from any mesen­chymal derivatives. The literature records its occurrence at all ages. Ocular presentations of malignant lymphoma are quite rare. Spo­radic case records are available in the literature on ocular presentations of lymphoreticular disease. [1],[5],[8],[9] We report here a case of reti­culum cell sarcoma producing bilateral prop­tosis.


  Case Report Top


S.R., a male child of 6 years was brought to the hospital with the complaint of progressive protrusion of the right eye ball of one month duration. A few days later the parents of the child noticed protrusion of left eye. Simultaneously a swelling was observed over the right mastoid region which had gradually increased and was painful. No history of fits, vomit­ing or headache was present.

On examination the child was drowsy. Bilateral, proptosis with limitation of all extraocular movements were noticed. Vision could not be assessed. Bilateral papilloedema was present on fundoscopy. Rest of the nervous system was normal. Swelling over the right mastoid region was two inches in diameter and anterior to the right ear lobule [Figure - 1].

Skin over the swelling was stretched, fixed to the deeper structures, firm in consistency, and was tender. Plane of the swelling was superficial to the deep fascia of the neck. There was no other similar swelling elsewhere in the body. Liver and spleen were not palpable. No other mass was felt in the abdomon. Lymphnodes were not enlarged. Heart and lungs were clinically normal.

Routine urinalysis was within normal limits. Blood examination revealed a total white blood cell count of 12,600/cumm. with 75% polymorphs and 25% lympho­cytes. Erythrocyte sedimentation rate was 16 mm/hr. (Westergrens) and haemoglobin was 10.2 G% (Shalis).

Cerebrospinal fluid analysis was negative for globu­lins with proteins of 30 mgs%„ sugar of 79 mgs% and chlorides of 669 mgs% with normal cell count.

Intravenous pyelography was normal. X-ray of the chest and abdomen were normal. X-ray of the skull showed sutural diastasis. Orbits were normal except for thinning of the orbital margins. Ventriculogram showed basifrontal space occupying lesion. There was no evidence of tumour in the posterior fossa.

The child deteriorated after the ventriculogram and expired on the next day.

Histopathology: Biopsy of the tumour over the right mastoid region revealed pleomorphic reticulum cells well dispersed and enmeshed in a fine net work of reticulum fibres. The tumour cells were traversed here and there by fibrovascular stroma. These cells had dense chromatin net work with well defined nuclear membrane [Figure - 2]. Silver impregnation methods did not show metalophilia. A histopathological diagnosis of reticulum cell sarcoma was made.


  Comment Top


Tumour arising from the reticulo-endothe­lial system may be either lymphosarcoma, reticulum cell sarcoma or Hodgkin's disease. Any of these tumours may involve the orbit primarily or as a part of generalised involve­ment. Raticulo-endothelial tumours of the orbit have been regarded as uncommon. [3] An incidence of 10 to 20% has been reported. [6],[7],[10]

Reticulum cell sarcoma sontetimes shows a rapidly advancing and fatal course. It spreads either locally or by blood stream. The course is chronic and unpredictable. Patients treated either by surgery and/or radiotherapy show a much longer survival rate than the untreated cases. [11] However, the site of this tumour in the orbit has definitely a worse prognosis than a tumour arising elsewhere, because complete removal of the tumour from the orbit is less likely.

Occasionally a reticulum cell sarcoma seems to arise in one portion of the lymphoreticular system and extends from this apparently primary site but much more frequently it pre­sents as multifocal system disease. It is very difficult to assess the primary site of origin in our case.

The present case is being reported because of the rare occurence of reticulum cell sarcoma producing bilateral proptosis.

 
  References Top

1.
Consul, B.N. and Kulshreshtha, O.P., 1963, Amer. J. Ophthal. 56, 462.  Back to cited text no. 1
    
2.
Dennison, 1955; Arch. Dis. Childhood, 30, 472.   Back to cited text no. 2
    
3.
Duke-elder, S. 1952; Text book of Ophthalmo­logy. 5, pp. 5553, Henry Kimpton, London.  Back to cited text no. 3
    
4.
Evans, R.W., 1968; Histological appearances of tumours, 2nd Edn. Livingstone Ltd., London.  Back to cited text no. 4
    
5.
5. Gupta, S.P., Pratap, V.B. and Kaul, R.L., 1972. Ind. J. Ophthal. 20, 189.  Back to cited text no. 5
    
6.
Haye, C., and Haut, J. 1966; Arch. Ophthal. 26, 183.  Back to cited text no. 6
    
7.
Mortada, A., 1964; Amer. J. Ophthal. 57, 820.  Back to cited text no. 7
    
8.
Mukherjee, K.C., and Deshpande, D.H., 1962; Jour. Postgraduate Medicine 8, 120.  Back to cited text no. 8
    
9.
Nirankari, M.S., Omprakash and Daljit Singh, 1961; J. All India Ophthal Soc. 12, 94.  Back to cited text no. 9
    
10.
Reese, A.B., 1963; Tumours of the eye. 2nd Ed. pp. 533, New York.  Back to cited text no. 10
    
11.
Stout, A.P., 1942; Arch. Ophthal. 118, 168.  Back to cited text no. 11
    


    Figures

  [Figure - 1], [Figure - 2]



 

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