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Ophthalmology

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21 out of 34
 

Which of the following most commonly presents as bilateral proptosis? (AIPG 2011)



A Chloroma

B Pleomorphic adenoma

C Fibrous histiocytoma

D Cavernous hemangioma

Ans. A Chloroma (Ref. Ophthalmology By Khurana 4th/pg. 489)

Chloroma [Granulocytic sarcoma]:

1. A chloroma is an extramedullary manifestion of acute myeloid leukemia;

2. It develops in 2–8% of patients with acute myeloid leukemia.Q

3. Immunohistochemical markers are positive in the neoplastic cells of granulocytic sarcoma for: CD33; CD43; Myeloperoxidase (MPO) and Lysozyme, while CD45RO is specific for Primary T-Cell Lymphoma.Q

Cavernous hemangioma

1. Slow-growing vascular tumor.

2. Most common benign orbital tumor in adults.

3. Visual acuity is often not affected.

4. CTscan:

a. intraconal well-defined enhancing orbital (usually intraconal) mass.

5. Treatment: observation or surgical excision.

Causes of bilateral proptosis:

1. Developmental anomalies of the skull:

a. craniofacial dysostosis e.g. oxycephaly (tower skull).

2. Osteopathies:

a. Osteitis deformans, rickets and acromegaly.

3. Infammation:

a. Mikulicz’s syndrome, and late stages of cavernous sinus thrombosis.

4. Endocrinal exophthalmos:

a. Thuroid eye diseases.

5. Tumors:

a. Symmetrical lymphoma or lymphosarcoma,

b. Secondaries from neuroblastoma,

c. Ewing’s sarcoma and

d. Leukemic infiltration.

6. Systemic diseases:

a. Histiocytosis, Syetemic amyloidosis, xanthomatosis and WG.

Head and neck surgery--otolaryngology By Byron pg. 1512:…………….

1. In adults, the most common cause of unilateral or bilateral proptosis is thyroid-related immune orbitopathy.Q

2. The most common cause of bilateral malignant proptosis in adults is lymphoma.Q

3. Cavernous hemangiomais the most common benign orbital tumor in adults.Q

4. The most common malignant orbital tumor in adults is lymphoma.Q

5. Breast canceris by the most common source of metastases to orbit in female. Q

6. Squamous cell carcinoma represents the most common adjacent neoplasm spreading to orbit.

7. Rhabdomyosarcoma is the most common primary malignant tumor of the orbit in childern.Q`

8. Dermoid cyst is the most common benign orbital tumors in childern.Q

9. Neuroblastoma is the most common source of orbital metastasis in childern.Q

10.In childern, the most common cause of proptosis is bacterial cellulitis (from ethmoid sinusitis)

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