目的:报告罕见突眼急性发作病例继发于皮下脂膜炎样T细胞淋巴瘤(SPTCL)1例。方法:病例报告。结果:患者,男,27岁,马来人,左眼眼球突出急性发病2wk。伴随长期高烧病史。在此期间他的身体和双大腿还多发肿胀红斑。双眼视力为6/6。左眼眼球突出和球结膜水肿。各个方向眼外运动受限。角膜和眼前段正常。眼底检查显示正常视盘和视网膜。右眼检查为正常。体温40.0℃,全身多发皮下红斑病灶主要分布在左腋下、右季肋部、双大腿和耻骨上区。腹股沟淋巴结也是可触及的。脑磁共振成像显示左冠外和眶后广泛软组织肿胀,暗示着炎症反应。海绵窦和大脑正常。红斑病灶处皮肤切片揭示为SPTCL。其被提交给血液病医师,并开始CHOP方案化疗。患者化疗反应良好,眼球突出复位。结论:眼球突出继发于SPTCL是非常罕见的。这是一个外周T细胞淋巴瘤的变异,特点是多发皮下结节表现为眼球突出和发烧。

AIM:To report a rare case of acute onset of proptosis secondary to subcutaneous panniculitis-like T cell lymphoma (SPTCL).METHODS:A case report.RESULTS:A 27-year-old Malay man presented with history of acute onset of proptosis in the left eye for 2 weeks.It was associated with history of prolonged high fever.He also developed multiple erythematous swelling on his body and both thighs during this period.On examination,visual acuity in both eyes was 6/6.The left eye was proptosed and chemotic.The extraocular move-ment was limited in all directions.The cornea and the anterior segment were normal.Fundoscopy showed normal optic disc and retina.The examination of the right eye was unremarkable.His body temperature was 40.0℃.There was presence of multiple erythematous subcu-taneous lesions over the body mainly in the left axillary,right hypochondriac,both thighs and the suprapubic area.The inguinal lympnodes were also palpable.MRI of orbit and brain revealed generalized soft tissue swelling in the left extraconal and retro-orbital space suggesting of inflammatory reaction.The cavernous sinus and brain were normal.Skin biopsy from the erythematous lesion revealed as SPTCL.He was referred to the haematologist and was started on chemotherapy-CHOP regime.The patient responded well to the chemotherapy and the proptosis reduced.CONCLUSION:Proptosis secondary to SPTCL is very rare.This is a variant of a peripheral T cell lymphoma characterised by multiple subcutaneous nodules presented with proptosis and fever.

R733.1